The Power of Communication

We've had this situation at work where us Nurses have not met eye to eye with our Manager. So you know what typically happens with that scenario... the Nurses talk and talk, getting madder and madder, more and more bitter... morale plunges and the negativity gradually infects everyone and everything. Sound familiar?

Today, I think I might have felt a little twinge of pride for my coworkers! Together we decided to arrange a meeting with our Manager. In an impressive display of professionalism (along with a great set of balls which I had never really witnessed) the Nurses presented their concerns to the Manager in an open and honest manner. The result was really impressive! The Manager responded very positively, the Nurses were all able to voice their opinions and in the space of an hour, all bad feelings were gone.

When communication is done right, there is little as effective! For the most part, Nurses often just want to be heard. Taking the time to listen is sometimes all that is needed.

Do Not Resuscitate (DNR)

Unit Fumigation

As an L&D nurse, whether we admit it or not, we occasionally have one of those days when we get our patient and wonder: Honey, how did you ever end up here?! Today was one of them. She was a sweet, young little thing with a rather lost look on her face. Her water had broken at 33 weeks and she was hanging out with us until 36 weeks, when she was going to be induced.

The problem was My God, She STUNK! I have to say, on L&D we get a plethora of smells (in our little world there is a stink, but when that has reaches the intolerable point, it becomes a stank). For the most part, we don't really acknowledge the wonderful smells... it's part of the job. This wasn't a normal smell. It was barnyard cow's ASS inside-out and multiplied by 2 years. How does a sweet, little girl get smelling like that?! I told the nurse who was taking her to make sure she got a shower before even getting into bed. Might as well start off right... but mostly I was thinking I would be inheriting the patient when this nurse went home at 3 pm!

The cause of the stank soon became clear. The men all (obviously, and that's never good!) worked on a ranch. Unmistakable stank. And the dirt left in the hallway didn't help either. Other visitors were complaining of the smell in the Waiting Room, we were gagging at the Nurse's Desk. One Nurse took the airfreshener from the bathroom and emptied it in the hallway. So now it smells like citrus crap. It was a rediculous scene.

Then she's assigned to me. I stood at her door, overwhelmed by the stank coming out. I couldn't go in! I couldn't deal with this for the rest of the day. The only way I know how to deal with this is to just keep it real. A good dose of authenticity, if you know what I mean. So, after far too long I took a deep breath and entered the room.

OH MY GOD! HAS IT SMELLED LIKE THIS THE WHOLE DAY?! I AM SO SORRY!!! IT MUST BE THE SEWER BACKING UP! LET ME OPEN THE WINDOW FOR YOU! WE HAVE GOT TO CHANGE YOUR ROOM!

Oh, God. I'm evil. I told the family that she would not be delivering today... they went to the waiting room as I moved her to the negative pressure room. Then we fumigated the unit and when the family wasn't looking we removed the antenna from the TV in the waiting room. They all went home and we didn't have another issue that day.

Pet Peeve #2: Posers and Wannabes

Posers. Here's a news flash, folks. I don't care if you work in the medical field! I don't care if you're a Paramedic or a Fire-Fighter (no need to wear the shirt!) or a Nurses' Aid or a Physician or Nurse of any sort. When you're in Labor and Delivery, sorry, but you know nothing. You're "Mom" or "Dad." So here's a list of hints you Posers may find helpful:

1. Don't wear scrubs. First of all you look like an idiot. Secondly, it makes me think you want to steal a baby. Finally, if you're doing it so that I'll ask you what you do - it ain't going to happen. Give it up.
2. Don't offer to start the IV for me. I don't need an anticubital botch-up. I'm pretty darn good at my job and I guarantee I can do it better than you.
3. Don't tell me you're a Nurse when you worked as a Nurses' Aid 43 years ago. I'm pretty sure that doesn't count... and I have no idea how that is relevant to the situation here.
4. Please leave your half-cocked Internet knowledge at home. It's useless, mostly incorrect and incomplete. I actually do know what I'm talking about and am not impressed with poorly pronounced medical jargon (especially EPIDERMAL!)
5. Don't tell me how to treat your wife's terrible pain when she has finally felt her first contraction. You're a Podiatrist, for God's sake, (yeah, you!). How about you give me a foot massage at the end of my shift?!
6. I don't bring drugs any faster because you've worked in a hospital before or because you stick your head out the door, which I find oh, so threatening!
7. Quit watching the Fetal Monitor! Do you really think you can interpret what you're seeing?! Quit or it's going off!
8. Finally, I take great offense to the insinuation that I would treat you differently because of your (actual or perceived) profession.

What's With the Dangling?!

Our L&D unit is down at the end of a long hallway (I can guarantee you a nurse wasn't asked about that one!). To get there, you must walk past the Post-Partum nurse's desk, then the nursery.

We were sitting around, enjoying a lovely Saturday afternoon in L&D yesterday, when we get a call from one of the nurses in Post-Partum. "Hey! Did you know you were getting a patient?" No. "Ok. Let me know what you think of her bra." She hangs up before I can get another word in. I peek into the strategically-placed mirror, giving me a view of the entire hallway from my seat. A poorly dressed, young, young girl waddles through the doors. Her boobs are hanging down, practically caught in her shoe laces, flopping this way and that with every step. It was hideous. I call Post-Partum. You're a wicked, evil old Hen! and slam down the phone.

The girl walks up to the desk. My "desk assessment" is giving me a blank. Hi! What can I do for you? "Umm... my, ummm, hip hurts." I'm wondering which part of "Labor" and "Delivery" that fits into... Ok. Who's your Doctor? (which really means Why didn't you call your Doctor???) "I don't have one here." Well surprise, surprise! Another (more tolerant) nurse takes the girl to a room. She comes out rolling her eyeballs. Turns out Droopy-Boobs is only in her mid-teens, pregnant with her second baby, alone, and clearly, cannot afford a bra. God, I'm evil.

Pet Peeve #1: Day Care Surprises

It seems to me like it's getting more and more common. Couples (who, I might add, have had 9 months to find a solution), come into the hospital to have their baby with absolutely no plans of what to do with their other kids.

Let's see... recently, I've been asked "Will you please look after the children during my wife's labor?" "Who is going to watch my daughter while my wife is in labor?" "What do you mean, you don't supply a daycare?!"

Are you folks kidding me?! Who, exactly, is going to look after your wife while I look after your kids?!

People are obviously so concerned with this that they ask all of the appropriate questions during their prenatal class and tour (Did you happen to see the daycare on the tour, perhaps?!). Or not. Do some hospitals provide daycare as a free service? I wasn't aware we were doing so well financially! At least it's not reflected on my check! And, most importantly, from where did this sense of entitlement come from?! Or wait... That's Pet Peeve #2...

Ah... The Things We Do for Our Job!

Another Weekend Shift

Another weekend shift done! Would you believe I actually love working the weekend?! There's a little crew that usually ends up on certain weekends, and patient-permitting, we sit around all day and laugh our asses off. This weekend was one of those. LOVE it!

We gossip about things that our significant others would be horrified to hear... we discuss which doctor is acting crazy this week and why... we howl over the guy from Dietary who thinks we crumble the crackers when he's not looking... we mock the nutty patients from the previous week (like the one who showed up because her stomach felt very full and the baby was moving very fast... Did ya eat a few pounds of chocolate, maybe?!)... and of course, we discuss the dispised Supervisor (whom we joke still breastfeeds her 20-something year old kids). Ah yes! Another weekend shift completed!

Crack Whores and Fakers

So... turns out the baby I delivered in the ER the other day is addicted to crack. Nice. I shoulda known. What first-time Mom comes in and delivers that fast?! Stupid backstreet crack whore. I hate that.

I had a pretty uneventful day today. Just a few triage patients... the regulars: "I threw up, so I thought I should come in." Did you call your doctor? "No. Can I have something to eat?" Sure... Would you like a mint on your pillow too??? Then there's the one who had contractions for 3 hours yesterday. Anything today? No... How the hell do you stupid people figure out how to breed?! Then there were about 3 "BP Evals" all from the same physician. Her BP is 104/63 - what exactly am I evaluating???

But what the heck, you need 'em every once in a while... I figure it's because we've delivered everyone within a 50 mile radius in the last 2 days. Should be good for a couple of days at least...

Students and Walk-ins

I clearly remember being a student. Even more clearly, I remember the nurses when I was a student. I swore to GOD that I would never be like those bitches. I was so appauled by their complete lack of compassion and empathy. I remember promising myself: If you ever become as cynical and disenchanted with the miracle of life as these nurses, you will quit. You understand me?! YOU WILL QUIT!!! I am now far worse than any nurse I've ever met and guess what. I'm still doing it.

Every once in a while an event brings the extent of my cynicism to my attention - today it was an innocent little nursing student caught in the crossfire of my annoyance.

First thing in the morning I was assigned a walk-in, Spanish-speaking only patient at 8 cm, going natural. She's under 30 and is having her 8th kid - but I won't judge (yeah, right!). I understand that walk-ins with no prenatal care are the norm in some hospitals, but not in the community where I work. They are few and far between. Perhaps because of our unfamiliarity with this population, our patience and tolerence with their situation is sorely tested. This particular girl was well-known to me. She'd come in a multitude of times (for what I assume were "prenatal visits") since being 20 weeks. There was never a babydaddy, just her multitude of unruly children who's apparent job was to be our translators. I had done everything I could possibly do to get her to seek care, short of dragging her to the clinic myself. Never once did she go. So I'm mad. 8 cm or not, I'm mad!

Along with a fresh nursing student, I walk in to her room. We're met with screams of the only English words she apparently knows: "My baby! My baby! My baby! My baby!"

Your baby is coming? I try to coach her in my rediculous, broken Spanish. It's not working.

"My baby! My baby! My baby! My baby!"

Ok. Let me check you. Let's see if it's time. I pull on a glove to do an exam. She either understands the words or the action - I'm never sure which.

"NOOOOOOOO! Contraction!" She grabs down at her crotch in an attempt to block me, at the same time getting bloody gunk all over her hand.

I wouldn't put my hand down there if I were you... Ewwww! Nice! Ok. Fine. I'll wait. I wait through the contraction and try again. I get the same response. So I continue to wait. The minutes drag... Each time I attempt to examine her I am met with the same holler "NOOOOOOOOO! Contraction!"

Ok, when you're ready for me to examine you, just call. I pull off my gloves and walk out. I'm done. She didn't care enough to get prenatal care... If she didn't care, why should I?!

The student is staring at me. I recognize the look. It's the same look I gave those horrible nurses so many years ago when I was a student. "WHAT was that?" she says. Good for her! She's got some balls! She'll make a great labor and delivery nurse!