Nurse Ratched's Place: February 2008

Get Your Hands Off My Organs

My husband and I have been married for ten years, and the poor guy can never win an argument. It's not allowed. In our household, the woman is always right. We agree on most things except when it comes to the issue of organ donation. I’m an organ donor, but my husband believes that being an organ donor makes an individual more vulnerable to abuse. He says that there are some sick doctors in the medical community that will kill patients in order to harvest their organs. I’ve always said that was bunk, but then I read a story in the New York Times that proves my husband's point.

A transplant surgeon is being accused of giving a patient heavy doses of morphine and Ativan to hasten a donor’s death. I gave the doctor the benefit of the doubt when I first heard about this story until I read that he is also accused of introducing Betadine into the patient’s system as a way of jumpstarting his death. The doctor’s attorney claims that nothing was done to hasten the patient’s death. Apparently, the nurses disagree. They are testifying on the behalf of the prosecution. I can only imagine what’s going to happen in court. If you were on the jury, who would you believe:

The surgeon accused of killing a patient for his organs, or.....

the patient’s nurses, who are testifying for the state?

My husband is never going to find out about this. I’m not breaking my perfect ten-year record of always being right.

Wanted: Nurses for American Airlines

Meet Nurse Sarah Bennett. She proves the old adage, “Once a nurse, always a nurse.” Nurse Bennett was tired of being just another pretty face at the office, so she became an airline stewardess. Here is her story:

“OFFICE DRESSING.” That, Sarah thought wryly, was exactly what she had been as a nurse to the handsome and successful Dr. Ralph Caldwell Porter. Looking wand-slim and elegant in her white nylon uniform, her heaviest duty had been to stand by serenely while Ralph administered to the imaginary needs of some fawning, simpering female. She needed a new perspective on her life, and time to think about Ralph. She had to decide whether she could marry a man she loved—but didn’t respect.

Now, as a newly appointed stewardess of the Alaska Passenger and Freight Airlines, she faced her biggest challenge as a nurse and as a woman. And what, Sarah thought desperately to herself was she going to do? The plane had crashed, and the passengers were all depending on her. Her passengers were dangerously ill, and the pilot was dangerously attractive.

Decisions, decisions. It sounds like Nurse Bennett has her hands full, but she’s a nurse, so you know everyone is in good hands.

Did you know that a long time ago, when commercial air travel was new, nurses served as stewardesses? These pictures are from a book in my collection. The transition from bedside nursing to serving tea and coffee was all about marketing. The airlines hired nurses to help the American public get over their fear of flying. After all, if air flight was safe enough for nurses, it was safe enough for everyone. And who else was better qualified to care for passengers just in case something went wrong?

Maybe American Airlines should revisit the idea of hiring nurses to serve as stewardesses on their flights. They are in deep trouble after a passenger died while begging for help. The 44-year-old woman was in respiratory distress, and her stewardess kept blowing her off. Then two doctors and two nurses on the flight stepped in and tried to save the woman’s life. They attempted giving the woman oxygen, but the two oxygen tanks on the plane were empty. Then the defibrillator that the plane was carrying didn’t work. American Airlines slogan is, “There is Something Special in the Air.” Maybe that something special should be a nurse.

Coffee, tea, defibrillator paddles?

Email From Mother

Poor Bill...

Psychiatric nurses are really good at reading body language, so my mother sent me this and asked me what I thought. Hmmm?

Choose the best answer:

1. Why did I marry her? Why didn't I just put a loaded gun in my mouth? Why God, Why?
2. Holy crap, look at that butt. Somewhere, a semi-truck is missing its 'Oversized Load' sign.
3. Somewhere, there's two fat girls naked in a hot tub and I'm stuck here listening to her jabber on about health care.
4. I wonder if they would let me change to be a Republican? We're soooo screwed!

Breakthrough Medical Technology Hits The Campaign Trail

I figured out a quick and easy way to decide who should be the next President of the United States. Let’s just give everyone running for President a brain scan. Think about it. Really, who wants their favorite television shows interrupted by endless political campaign ads? Let’s just scan everyone’s head, hand over the White House keys to the candidate with the best looking brain, and get back to watching Desperate Housewives. How accurate are the test results? You decide.

This is George Bush’s brain scan.

I want to thank Scalpel for calling this to my attention. Enjoy your weekend.

Stop the Presses!

It looks like something big is happening in the newsroom. I was studying journalism, but I gave it up when they told me I had to be able to run a three-minute mile. Look at those newspapermen run without breaking a sweat. They sure look excited about something. I bet they are running to check out Grand Rounds and Change of Shift. You should run and check them out, too.

There’s a lot of breaking news out in the blogosphere. The big news is about Adrienne Zurub. She is a nurse who worked at the Cleveland Clinic for twenty-six years. Then she got fired. Why? She wrote a book about her life. Needless to say, her former employer was not amused by Adrienne's thoughts about working as a nurse. Adrienne speaks for every nurse who has seen abuses in the health care system. Adrienne is a nursing hero. Good luck getting your hands on her book. The last time I looked it was sold out on Amazon.com.

Chris Seper, the online medical editor at The Plain Dealer, the daily newspaper in Cleveland, Ohio, wrote to me and said that his paper had just published an article about Adrienne. Chris was shadowing a surgery team at the clinic when one of the nurses pulled him aside and filled him in on what happened to Adrienne. Here’s a link to the story about Adrienne, written by Michael K. McIntyre, and here’s a link to excerpts from Adrienne’s book. Michael and Chris are good newspapermen. I bet they can run a three-minute mile.

"Would You Believe...?"

Do you remember Maxwell Smart from the 1960’s hit television show, Get Smart? Every week Maxwell and his partner, Agent 99, would fight evildoers working for KAOS. Maxwell had a habit of making up stories, and he would start out by using the catch phrase, “Would you believe?”

There are a lot of things that you would never believe about the health care system, even if I could tell you the whole truth. I’m going to let you in on a little secret about my blog. There are some days when I feel like a huge liar. I’m not making stories up, really, this stuff happens, but I’m lying to you by omission. There are two main reasons why I must filter my stories. The biggest reason is HIPAA, that annoying law that keeps all health care bloggers from telling the whole truth about what goes on behind closed doors. The other reason involves credibility. A sane individual would never believe what really goes on inside of a hospital. The events defy rational thought.

You may be asking yourself, “Gee, Mother Jones, what’s up? Why are you feeling so glum?” My weekend didn’t start out well. I found a subpoena in my mailbox at work. No, I'm not being sued. I witnessed a crime on my unit. Remembering the cautionary tale of Dr. Flea, I will not go into details about the case, but let’s just say that my life is going to turn into poo within the next few weeks. I’ll also be avoiding certain parts of town, and I won’t be going out in public. And then there was the news that I received last night at the end of our shift. One of my former patients committed suicide. He was a kid, a sweet child who told everyone about how his crack head parents were abusing him at home. Again, the details of this case defy rational thought, and I can’t say anything else because of legalities. He said he would kill himself someday. Some things are just too heartbreaking to believe.

Goodbye, Sweetheart. You’re safe now. I hope you find peace with the angels.

Happy Valentine's Day

I gave my husband a Valentine’s Day card this morning. He blushed and now he’s out running errands. Poor guy. I hope he brings home jewelry. It’s the only thing that’s going to get him out of the doghouse.

Bark!

Happy Valentine’s Day everyone.

Another Study Proves the Obvious

A study conducted by the joint Healthcare Commission and Royal College of Psychiatrists found that psychiatric nurses are at high risk for being assaulted at work. Really? Imagine that, nurses who work with violent patients get hurt. I wonder how many man-hours and how much money went into creating this earthshaking report.

File this study under the category of, “Well, Duh!?” Thanks to Beakie from Mental Nurse for bringing this article to my attention.

The New Job

This is all wrong. There is no personal contact allowed between staff and patients on a psychiatric unit. And check out what our nurse is wearing. Her outfit is scandalous, and she’s wearing white lace-up high heels shoes. And that nurse’s cap! I wonder what nursing school handed those things out. Our little nurse better get her act together before her employer shows her the door. Take it from me, it's hard finding a new job that you like.

I went to a job interview the other day, and I’m now working four hours a week at a drug rehab clinic. I think I’m going to like the job because I’m not in charge of the place when I’m there. The program is counselor driven, and I’m just there to pass the pills. That means all I have to do is call a counselor if someone starts acting out. People aren’t coddled at this place. They follow one basic guiding principle: Act like a descent human being, or get the hell out of the program. I have finally found a place that matches my personality.

My job interview was an unique experience to say the least. I spent hours preparing, and I found just the right outfit to wear to my interview. I looked really sharp in my navy blue suit and new winter coat, but then it started raining, and I fell into a mud puddle as I raced out of the house. I ended up arriving for my interview wearing a pair of khaki pants and a mismatched turtleneck shirt. I handed a mud-splattered resume to my new boss, and she hired me on the spot. She was impressed that I showed up for the appointment, mud splatters and all, and she especially liked my wrinkles and gray hair. She said that she liked my maturity. She said, “Young nurses that look like kewpie dolls don’t work out. The patients respond better to women who look like their mother.” Finally, age discrimination that worked in my favor.

In your face, kewpie dolls.

Hillary Sinks in the Potomac

My friend sent me this last night. I think it’s cute. Happy Valentine’s Day, Hillary.

What Do You Hear at Change of Shift?

I confess, I procured the guy using this primitive hearing aid from Johnson and Johnson’s blog, JNJ BTW. I’ve always wondered how much you can hear by using one of these things. They look awkward and hard to use. I bet this guy is listening to the nurses over at Nursing Voices. Nurses from around the world are gathering at the Nursing Voices Forum. The conversations are insightful, as well as entertaining. No wonder the guy is listening in with his ear horn. He doesn't want to miss anything that they are saying.

Kim from Emergiblog is hosting Change of Shift over at Nursing Voices. There are some really great posts up, and you should go check them out.

Who's Running the Asylum?

Meet Nurse Kit Jessop. She’s young and energetic, and she loves her job. Notice how she smiles as she walks the halls of her unit. She is holding her head up high because she has confidence in her nursing skills, and in her ability to make patient care decisions. Everyone, including the doctors and the hospital administrators, respect her as a health care professional. This book was written during a time when nurses were truly in charge of their units. We told hospital administrators what we needed to do our job, and it was the administrator’s job to meet our needs. Patient care was nurse driven, and the patients’ needs came before anything else.

Nurse Jessop wouldn’t be smiling today because, sadly, those days are gone forever. Nurses are marginalized, and are frequently ignored when they advocate for their patients’ needs. I admitted a patient last weekend that made me cringe. Due to HIPAA regulations, I can’t tell you the details, but let’s just say I wouldn’t want this individual hanging around a playground. I placed the patient on our highest observation level, and called in additional staff to watch the new patient’s every move. I was very concerned for the safety of the minors on our unit, so I called our medical director to tell him what was going on. Here’s a little bit of our conversation:

Doctor: (Yelling) Why did you place this patient on one-to-one observation? He hasn’t done anything while he has been on the unit. Take him off one-to-one observation.

Me: The best predictor of future behavior is past behavior, and we have children on the unit.

Doctor: (Shrieking): Give me one good reason why we should keep the patient on one-to-one.

Me: So we don’t get sued.

That comment turned the tide. Screw patient safety, it costs too much to bring in an additional staff member to ensure the safety of the other patients, but god forbid we get sued. This is crazy. Hospitals are turning into asylums because nurses aren’t in charge anymore.