One Last Thought

The naked truth is still taboo. Bob Dylan


Enjoy your holiday weekend....

Nurses, Drug Reps, and Viagra Pens

There is an interesting new blog on the Internet that you should go check out. It’s Johnson and Johnson’s new corporate blog, JNJ BTW. I started leaving comments over there a couple of weeks ago, and now I’m getting hits on my own blog from J&J. I hope some of my new readers are drug reps. I want to help them learn how to get along with hospital staff so they do not suffer their own death at the hands of a nurse.

Nurses have a love-hate relationship with drug reps. There are days when we don't have time to listen their spiel, and they always seem to come to the unit during the most inopportune times. Seasoned reps know that the fastest way to a nurse’s heart is through his or her stomach. Reps who excel at their job bring in deli food when nurses are trying to get off of the unit for lunch. Reps who haven’t learned this lesson arrive during mealtime empty handed; these reps are doomed. I once refused to talk to a rep during an evening shift until he brought pizza to the unit. He was a new rep, and he thought I was kidding until I gave him directions to get to our favorite pizzeria and then I showed him the elevator. He came back to the unit an hour later with pizza and flowers for the staff. Nice touch.


Nurses also demand pens and other goodies when drug reps come calling. I don’t know why for sure, but I think it’s because we know that the drug companies are giving things to the doctors, so we want some stuff, too. Nurses covet Viagra pens, so if you are a Pfizer drug rep, you better have a lot of those pens in your pocket when you walk onto a nursing unit. I, however, think Risperdal popcorn is the best goodie under the sun. It is easy to cook, contains no active drug ingredients, and it is a quick, healthy snack when nurses don’t have time to go off the unit to eat. I know that Ed Silverman from Pharmalot wrote a salty review about the product, no pun intended, but I love the popcorn, and so do other nurses who have been forced to work a double shift without getting a break.



My sincerest thanks go out to Johnson and Johnson for making Risperdal popcorn, and for their other groundbreaking work in developing new goodies for nurses who love to eat.

Learn Something New at Grand Rounds

Our lecturing physician, Dr. Mustache, enjoys teaching people about new ideas, and he is telling his students and his patient about Narrative Medicine. He is really excited about the concept. What, you've never heard of Narrative Medicine? Then you need to cruise over to Grand Rounds. This week's host, Susan Palwick from Rickety Contrivances of Doing Good, talks about Narrative Medicine, and she has put together a great selection of posts. Go check it out. I am sure that Dr. Mustache will be reading all of the submissions after class.

All the Things I Wish I Could Say to My Patients Who Need a Kick in the Pants.

I had another challenging weekend at work. I am ordinarily a patient person with a long fuse, it takes a lot to set me off, but even I have my limits. There is a segment of the population that I have a hard time working with on a daily basis. These people are drug addicts who believe that the world owes them whatever they want whenever they want it. They typically are demanding, blame everyone else for their problems, and refuse to take responsibility for their actions. I am sure that the young lady in the picture is telling her boyfriend that it’s his fault that she is a junkie. After all, she wouldn’t be forced into using illegal substances if he were only a better person. How dare he interfere with her right to do whatever she wants to do! These patients are a walking nightmare. They don't respond well to unit rules or, God forbid, limits on their inapproperate behavior.

It’s really hard not to tell entitled drug addicts to go jump in the lake, but since I can't afford to leave Hospital X right now, I’ve learned to keep my thoughts to myself. Here are the things I’d like to tell people who abuse drugs and overwhelm our health care system.


Now Hear This…….


Shut up and stop griping. You are a screw-up and your own worst enemy, so stop blaming everyone else for your problems. Your family members, friends, or significant other didn’t hold you down and make you shoot-up, smoke, snort, or ingest harmful substances. Grow up and start taking responsibility for your actions.

You're right, life isn’t fair, but that doesn't give you the right to be a jerk. Stop demanding that people enable you. The world is a tough place, so grow some balls and start acting like an adult.

Stop making excuses for your actions. Maybe your brain is different than a normal brain, and that you crave substances because you are hardwired differently than everyone else. So what! Maybe you haven't heard this, but you have free will. You can choose to change you life. Granted, it’s not always easy to do, but it’s the first step to staying clean and sober.

And for God’s sake, don’t tell me that I have to jump through hoops to make you happy because you are paying my wages. My tax dollars are paying your hospital bill so shut the heck up.




Here is some advice for nurses who work with drug addicts. Bring in lots of Little Debbie snack cakes the next time your unit is overrun by drug addicts. Place the snack cakes in a basket and put them in the patients' lounge. The sugar in the snack cakes will temporally sooth your patients’ craving for drugs, and it will keep them away from the nurses station for a few precious moments while you get some of your charting done.

It's Roundup Time at Change of Shift

Howdy, Partners. Welcome to Change of Shift, Volume II, Number 5. My mailbox was full of great submissions, and I want to thank everyone for sending in their posts. Today’s roundup includes some of the best posts from blogosphere, so saddle up and enjoy this edition of Change of Shift. And speaking of mail, have you sent a letter yet to your representative on Capitol Hill, asking them to support legislation to establish the Office of the National Nurse? To learn more about the proposal, check out this post from the National Nursing Network Organization. I think it's a great idea. Click here to sign the online petition.

I want to thank Kim from Emergiblog for allowing me to host this week's CoS. Check out her post about two seniors, and prepare to laugh your socks off.


Hey, what are you doing? Whipping someone is NOT therapeutic. I’ve heard of new age medicine, but this is really over the top. I wonder what name you would give to this type of practitioner. Lonesome Dreamer from The Making of a Nurse might have a few ideas. Read LD’s post, Nurse By Any Other Name.

Compu_Nurse wants some ideas on how to tame her aching back. I do not suggest trying Medicine Whip therapy for a sore back.


Caroline from Brain Scramble sent in this book review. The book discusses the differences between Western medicine and Hmong medicine. Caroline must love books, too.




I wonder if cowboys fear engaging in a gunfight during a blood moon just as much as nurses fear working during a full moon. It’s a fact; hospitals get busy during a full moon. I don’t think I'd like looking at a blood moon. I’m not a big fan of blood, hence I am not a surgical nurse. It’s a good thing that nurses like different specialties. Terry from Counting Sheep loves surgery, and she sends in this post about the best case of the week.

Working in an emergency room is hard enough on a good night, but it can get very stressful when all of your exam rooms are packed with patients during a full moon. ERnursey sent in this post about the importance of having an experienced triage nurse working in a busy emergency room.


Faith Walker from The Oracle sent in this post about a brilliant doctor and an even more brilliant patient. Funny things happen during a full moon, too.

Emergency room nurses see a lot in their line of work, and Girlvet asks the question, "Can you work in an ER and still be nice?'' See her answer here, and tell her what you think.



Taverns are loud, rowdy places. They are full of drunken cowboys who yell and fight, and shoot at each other when someone cheats at the poker table. No one can relax and listen to the piano music with gunfire going off in the background. Look at these two cowboys. They are trying to kill each other, which is adding to everyone's sensory overload. Keith from Digital Doorway knows what sensory overload feels like. Check out his post.

Monkey Girl from Musings of a Highly Trained Monkey can handle anything that comes her way. I bet she can even tame drunken, rowdy cowboys. There is one thing, however, that grosses her out. It has to do with a tooth brush and a cat.




Arizona Cowgirl looks like she has her hands full. She’s just fallen to the ground, her shirt is ripped, and her horse is going berserk. She needs help. Before she rides off into the sunset with her hero who wears a white hat, Arizona Cowgirl should read this post written by tofu lou from manifest destiny about skin cancer. A cowgirl who spends all of her time out on the sunny prairie can’t be too careful when it comes to her health.

New Nurse Jane felt like she had been thrown off a horse when she volunteered to work some extra hours on her unit. Read her post and she will tell you how she learned to say no to overtime.

Markie from Mark on the World thinks that some nurses are meaner than a wild, out of control horse. Read his post about mean nurses.



The Texas cowboy holding the lit fuse connected to the power keg looks upset. He’s going to need an emergency room if he doesn’t settle down and come to his senses. Why would anyone argue with a lawman that is holding a gun, or stand around a power keg that is going to explode? It looks like some people in Texas are just plain loco.

Not every Texan is crazy, in fact, some of the best health care bloggers are from the great state of Texas. For example, Scalpel, from Scalpel or Sword, is an ER doc working in Texas. He wrote about stupid rules made up by stupid hospital administrators.

Tammy Swofford is a nurse writer from Texas who sent in this heartfelt post about grief. Her submission is a tribute to the victims who died in the Minnesota bridge collapse.





Here’s the Tender Foot Kid. He’s holding onto the bars of his jail cell because his feet hurt. I wonder if his mom is planning to tag along with him when he goes to have his tender feet checked out by a health care practitioner. Max E Nurse sent in this post about adults who can’t untie their mum’s apron strings. Maybe the Kid's mother will ask the doctor to order a colonoscopy for her son. Eeewww! Geena from Code Blog sent in this submission about a possible alternative for the dreaded golytely prep.






I’ve heard that we have to play the cards that life deals to us, even if we are the victim of a “Double Deal.” Craig from Second Chance to Live writes an inspirational post about his life, and how he is living to the fullest even though life dealt him a bad hand.












Here is Jake Kilgore, Frontier Lawyer. I hope the guy on the horse isn’t one of Jake’s clients. It would make me think twice before hiring Jake as my attorney. I wonder if people walk up to Jake when he’s walking down the street and ask him for free legal advice. Patients frequently walk up to nurses they know out on the street and ask for health care advice. Labor Nurse writes about how a patient walked up to her in a grocery store and started asking questions about mucous plugs.

The Curmudgeon is one of my all time favorite bloggers. He's been reading health care blogs for a long time, and recently told his readers that his daughter is taking her prerequisites for nursing school. He's a lawyer with a great sense of humor. Read his list of what NOT to say to a judge. Maybe he can give Jake some tips on how to save his client's neck, no pun intended.



The only law in the Wild West was gun law. Now we have a federal government making policies that don't always make sense. Disappearing John writes about a new policy in his post, Scary News Article. The Nurse Practitioners Save Lives weighs in on the same new policy in her post, Medicare Won't Cover Preventable Errors.

Disappearing John also sent in this post about the saying, “the more you learn, the more you realize how much you still don’t know.”





That's it for this week's edition of Change of Shift. Thanks for stopping by. I'm buffing up my boots and getting ready for the next edition of CoS. Someday Nurse from How I Spent My Nursing Education is hosting, and these boots are made for walking. Sorry, I couldn't help myself, I just had to say it. I'll see you at the next Change of Shift!

Change of Shift

Howdy! This week's Change of Shift is going to have a Western theme, so send your submissions in today. No, your posts don't have to be about barrel racing, cattle rustling, or singing around a campfire after a long hard day of the prairie. Just send me your favorite posts. Send your submission to motherjonesrn AT yahoo DOT com by Aug. 22. at high noon EST.

Back to School Advice From Your Mama

The first day of school is just around the corner, and a lot of people are ecstatic. Trust me, parents from around the country have been marking the days off on their calendars in anticipation to the upcoming event. Students however, have mixed emotions about going back to school, especially nursing students. On the one hand, nursing students look forward to entering a profession that is held in high esteem, but on the other hand, they know that their life is about to be turned up-side-down. Never fear, Mother’s here, and I’m going to give you some tips on how to survive nursing school.



Here is student nurse Gail Weston. She is the picture of perfection. Her blue dress and white pinafore are spotless, and her nursing cap is sitting on top of her head like a crown. Nothing rattles her. She remains calm when everyone around her is loosing their cool. Do you need a student nurse in the room during code blue? Gail performs perfectly under pressure. She’s tireless, and she’s smart as a whip. Gail never misses a single answer on any test. What’s her secret to being the perfect student nurse? It's easy to be perfect when you are a fictional character in a book. There is no such thing as a flawless student nurse. Do your best when you are in school, but don’t make yourself crazy by striving for perfection.



This is student nurse Shirley Davidson and her heartbreak boyfriend, Dr. Gerald Trent. He’s whispering sweet-nothings into her ear. Shirley isn't sure if she will have the strength to give up her social life. Student nurses don’t have to completely give up their social life, but sometimes they definitely have to put it on the backburner. You can’t do well in your classes if you’ve been out partying the night before, and your instructors and fellow students will not think highly of you if you come to class smelling of alcohol. Granted, everyone needs to have a little fun, but it’s no fun taking a test, or taking care of patients while nursing a hangover. And yes, you can still have a love life while you are in nursing school, but your partner needs to understand that studying for school is going to take up most of your time. If your significant other really loves you, he or she will understand, and do whatever it takes to get you through school.



Unhand that woman, you fiend! You have no right to hurt her just because she’s a student. Students have rights, too. You have the right to work in an environment that is supportive and free of hostility. Unfortunately, there are people who enjoy being mean to students, but don’t let them get away with something that they shouldn’t do. Talk to your instructor if someone is disrespecting you, or if you are being abused.



Embrace your time in school. There are going to be days when you hate going to class, but it is your pathway to a more fulfilling and rewarding life.

What Would Clara Think?

My favorite historical figure is Clara Barton. I know that a lot of people think of Clara as an antiquated relic, but she was really quite a gal. Clara voluntarily obtained and distributed supplies to wounded soldiers under horrific battlefield conditions during the civil war, was an outspoken advocate for women’s suffrage and civil rights for African Americans, and was the founder of the American Red Cross. Clara was well connected, too. Her circle of associates included Frederick Douglass and Susan B. Anthony, and she achieved her accomplishments during a time when most Americans believed a woman’s place was in the kitchen. More remarkably, she accomplished all of these things while fighting her own battle against depression.


Clara was a brilliant woman, so I've often wondered what thoughts she would have concerning recent events. For instance, what would Clara think about the court battle going on between Johnson and Johnson and the Amercian Red Cross? I'm not a lawyer, so I’m not going to comment on the merits of the case, but Johnson and Johnson is suing the American Red Cross for copyright infringement. I checked out jnjbtw.com and read what Johnson and Johnson was saying about the case,and while I was there, I found a link that leads readers to a post about Clara Barton. Clara signed an agreement with Johnson and Johnson, which allowed the company exclusive rights to use the red cross as the company’s trademark. I think Clara would be rather surprised by the lawsuit. She always believed that people should sit down and talk their problems out.


There was one other story in the news today that made me take pause. I wonder what Clara would say about Hillary Clinton's interest in a nurse's life. Keep your comments clean.

Update: Here is a link to some additional information about the lawsuit between JNJ and the ARC.

One Dead Under the Cuckoo's Nest

There are days when I feel like this nurse after I'm done working my weekend shifts. No, that’s not me on the cover. I gave up wearing hot pink stilettos a long time ago. They really hurt my feet. I’ll give you three guesses as to why this is my new all-time favorite book, and the first two guesses don’t count. Lori Avocato sent this book to me. She’s the author of One Dead Under The Cuckoo’s Nest. She had a sneaking suspicion that I’d enjoy her book.

The book’s main character, Pauline Sokol, is a former nurse-turned- p.i. who finds herself investigating a sleazy psychiatric insurance fraud scam, but there’s one catch. She is forcibly committed to a mental institution. Pauline is certainly sane, but she can’t get the nuns who run the place to believe her. Even her hunky, crime solving partner Jagger is unwilling to spring her, so she’s got nothing but time to keep digging into the case until it's solved. The book is full of twists and turns including the death of a gender confused “sister.” Nuns? Scams? Sexy crime solving partners? This book is a must read.

As the proprietor of Nurse Ratched’s Place--and who knows more about a Cuckoo's nest than Nurse Ratched-- I give Lori’s book a thumbs up. That a girl, Lori, and keep up the good work!

For more information about One Dead Under The Cuckoo’s Nest and Lori’s other books, check out her website, or click here to read an article about Lori that appeared in Advance for Nurses.

It's New, It's Blue, It's Change of Shift

Change of Shift is up at Emergiblog. Go check it out. I love the new CoS logo. It's so BLUE.

Wipe Out!

Surf’s up, Dude. Look at our winsome nurse hanging out at the beach. I wonder if her cap is waterproof. Ron Tercotte is holding the surfboard. He's the doctor who ran away from his brilliant medical career to become a beach bum. Maybe doctor Tercotte decided it was easier to catch a big wave than it was to get paid by an HMO. Prehaps we should all start thinking about hanging out at the beach.





I’m still looking for a new and exciting career in nursing. Has anyone seen an ad like this for a surf nurse?

Wanted:

Nurse to work on a resort beach. Must know how to swim, shoot the curl, and hang ten. Also must know how to save drowning victims while running in slow motion like they do on the TV show, Bay Watch. Duties include beach combing, attending beach parties, and participating in beach volleyball tournaments. Applicants must have expertise in mouth-to-mouth resuscitation, and know how to slather on sunscreen. Female applicants must provide their own uniform consisting of an itsy bitsy teenie weenie yellow polka dot bikini. Male applicants must supply their own Speedo. Please send your resume to In Your Dreams Recruiting Agency.


If you see an ad like this, please let me know.

Got God?

This is the Hindu goddess, Durga. Look at all those arms. This goddess gives a whole new dimension to the term “multitask.” According to Wikipedia, Durga is the embodiment of feminine and creative energy. I think she’d make a great nurse. She rides everywhere on her lion, so her legs would never get tired, and she’s apparently very good at fighting demons. I’d like to see someone from hospital administration try bullying her into accepting an unsafe patient care unit. She’s my kind of deity.





I could have used some of Durga’s energy today. I’m so tired after working my weekend shifts. I was surfing the web this morning at my favorite Panera Bread coffee shop when a very handsome, well-dressed, young man walked up to my table and struck up a conversation with me about my Mac computer. He was charming. If I were thirty years younger, I would have thought he was hitting on me, but since he was young enough to be my son, I wondered what he really wanted. I knew this kid wasn’t going to ask me for my phone number. After spending a few minutes talking about why everyone in the world should own a Mac, he said he wanted to give me a small gift. He reached into his briefcase and pulled out a DVD about his faith, and he asked me if I believe in God.

Almost everyone that I know who works in the health care field believes in a Higher Power, but they don’t talk about their religious views at work. My nursing instructors taught me that it is taboo to talk about religion, especially with my patients. Then one day I saw a surgeon kneeling by a patient’s bedside because his patient had asked him to pray with her. She told him that she was about to die. The doctor was praying and holding her hand when she slipped away from earth and entered into heaven.




I was given a copy of “The Nurses’ Pray” at my capping ceremony many years ago that asked God to provide nurses with the strength to work as subservient handmaidens. Ok, it didn’t exactly say it in those words, but it implied that nurses must meekly follow the doctor’s orders without question, and perform backbreaking labor because God said so. The prayer is outdated, so I’ve taken the liberty of updating the prayer.





The New Nurses’ Prayer

“Dear God, please get me through this shift in one piece, and keep my patients safe. Please don’t let this be the day that I make a mistake that costs one of my patients their life. Protect me from physical blows delivered by violent, unruly patients and their marauding family members who demand services that the hospital cannot or will not provide. Allow me to give good patient care because it is the right thing to do. Help me keep my sense of humor while I stand in the midst of chaos, and please keep my mind focused and sharp so I can get through another grueling shift. Please forgive me for all of the swear words I utter under my breath at work, and I humbly ask that you provide a legion of new nurses for the profession so I can retire soon.”

Amen.


I’m convinced that the only thing that keeps me in nursing is divine intervention.

Why Are Graduate Nurses on Today’s Menu?

I’ve always been able to pick out the new nursing graduates who report for their first day on the job. Look at this young lady. Her uniform is spotless, her cap is impeccable perched on top of her head, her hair is perfectly coiffed, and she made the mistake of wearing high heel shoes to work. Didn’t anyone tell her about Nurse Mates? She’s going to have some really bad blisters by the time her shift is over. The biggest tip off, however, is her demeanor. She has the new graduate glow. Her shoulders are pulled back, she’s standing straight and tall, and her head is held up high. She’s full of confidence and pride.

Now imagine our fair young nurse’s arrival on her unit for her first day at work. Her new coworkers, who are sitting in their faded scrubs and mileage worn work shoes, barely have time to notice her entering the nursing station. The nurses from the previous shift are ignoring the relentless buzzing of call lights in the background as they hurry to get their charting done so they can go home. Their back and legs hurt, and the last thing they want to do is make one more trip down the hallway in order to put another patient on a bedpan. The nurses reporting for work aren’t happy either. They are preparing for another long, difficult shift. In the middle of the chaos stands our perky new nurse, bright eyed and full of zip. The old warhorse nurses take one look at her and the feeding frenzy begins.

(Warning: I’m about to get on my soapbox, so watch out.)

How many times have you seen this happen at work? Experts call it lateral violence in the workplace. Nurses call it eating our young. I’ve seen it a lot. In fact, I was a victim of this phenomenon. One group of nurses that I use to work with refused to talk to me unless it directly involved patient care, and they wrote me up for any little infraction that they could find or invent. A few of them even told me that I was a horrible nurse and that I should leave the profession. I cried a lot, but fortunately I’ve always been obstinate and I told the battleaxes to take a hike. I've never forgotten the pain that they caused me, and since then I’ve vowed to treat all new graduates with respect. If cheerful new nurses irritate you, so be it, but look at the situation logically. Who is going to take care of you when you are old if you keep running the newcomers out of the profession? Graduate nurses deserve our support, even the perky ones who report to their first day of work in high heel shoes. I'm not forgetting the guys. They deserve our support, too.