Nurses Eat Their Young

For anyone not in the business of nursing you have no idea of the very tasty treat that is a nursling. Their fear is delicious and their eagerness keeps them coming back for more of your feasting, er, wisdom?  This is as ridiculous as it sounds. Some nurses, sworn caregivers, pick on our newest members.  

I hate to admit this, but I too have picked on a student nurse, a new nurse, and a younger nurse. It’s not like I can take out my crappy day on my patient or a doctor!  Nope. Never.  I am on occasion a Florence NightenFAIL and have made those bright eyed nurslings a little weepy. I’m not proud of myself, well, that one time I sent the most annoying student ever on a hunt for left handed IV catheters still amuses me.

I regret that I wasn't the professional I like to think I am at times. The time I snapped at the new nurse during report when I questioned a blood pressure of 68/43 and she looked at me with innocent doe eyes and asked, “Is that bad?” I wish I would have had a brilliant teaching moment instead of word-vomiting “Yeah, it is bad! We are a critical care floor and that is critical! He could be in there bleeding to death?!?!?” While I stalked down the hallway to the patients room to check on him. 

Or the time I made the day shift nurse stay late to fix all the things she thought she was going to leave for me on the night shift. I could have offered to help her, or at least not complained about her the whole time despite her efforts to get it together.

These two nurslings did learn something from their encounter with me even though I was a total jerkface. The next time a blood pressure was off she proudly told me how she’d handled it. The other nurse actually pulled me into the patient's room to show me how well she’d done with the dressing changes.

I’ve definitely been a bit harsh, a lot impatient, and lacking in grace when dealing with the noobies. Lucky for me, or them really, they have been pretty few and far between and I am overall an advocate for the student and the new nurse. I love students and teaching people, but I’m human.

Now, to the nurslings, we like you, we don’t mean to upset you, terrorize you, make you question your choice of profession, and sanity. Almost all of us anyways, I still have teeth marks from the nurse who feasted on my tender noobie heart.  I know it is hard, I DO, I swear. Try to learn something from our less than caring moments, because you will have patients and their families mistreat you, and doctors will not hesitate to attack. You will need to smile and act like it doesn’t bother you.  

Just know that you won’t be the noobie forever and hopefully you’ll have a little more grace and mercy than the rest of us.

Is it syncope or gravity?

Sometimes I want to march down 7 flights and through the underground labyrinth into the Emergency Department and find the doctor that admitted an obviously drunk patient with syncope and yell “Drunky had a run in with gravity not syncope!! Discharge them at once!!!” I don’t of course, because that would be unprofessional.

What’s syncope? Syncope is a fancy-pants way to say fainting. The blood flow to your brain box was interrupted and down you went. Ouch.

What are some causes of syncope? Syncope can sometimes be caused by neurological problems like seizures. Neuro-cardiogenic syncope, doctors don’t fully understand why some people develop this type of syncope caused by an imbalance in the autonomic nervous system (ANS). The ANS is the involuntary operation between the brain, the heart, and the blood vessels. This type of syncope results in an inappropriate relaxation of the blood vessels leading to low blood pressure.  

The two most common causes of syncope are related to the heart or the blood vessels. Fainting is most often the body’s response to low blood pressure. Some causes of low blood pressure are dehydration (Okay, okay, so that drunk could be dehydrated, don’t rub it in), heart arrhythmia, and occluded blood vessels of the neck. Think of a time where you strained on the toilet and then felt lightheaded or maybe you've held your breath too long, or read about that really stupid choking game kids play.These are all examples of impaired blood flow to the brain. 

The best ways to prevent syncope? Hydration with non-caffeinated beverages. Caffeine can cause dehydration by increasing the flow of urine. If you are prone to fainting learn the warning signs, such as dizziness, weakness, blurred vision. 

If you feel a faint coming on take antigravity action…Lay down. Lying down allows the blood that may have pooled in your lower body to return to your heart to be pumped to the brain, and you can’t fall off the floor, so you’ll also avoid injury by being proactive.

We could be here forever talking about what could make a person fall out. You get the point. Syncope is fainting. Not all falling is fainting. And yes, that drunk could have had a syncopal episode. Sheesh. 

I’m a super superstitious nurse.

Superstition is the irrational fear that something bad will result from a particular action. Ummm, it’s basically nursing science and should be respected at all times.

“The board.” The board is the brain of the floor. It lists all the important information for the floor at a glance and if you touch it, change it, or comment on an empty box you asked for it. Why? If you say “wow, no code strokes on the floor,” or “wow, look at all those do not resusitates.” That will change in the worst way possible. Only the sacred hands of the charge nurse can touch the board and not have any negative repercussions.  

(Don't make me do this to you.)

“The Q-word.”…oh, you know the Q-word so I won’t jinx this post by spelling it out. Some equally awful synonyms for the Q-word are slow, dead, silent, low census.  It’s okay to think it to yourself, but you will be mobbed by angry nurses it you utter the Q-word at the nurse's station.

Why? Because after you've been thoroughly snipped at by your coworkers all hell will break loose on your floor. You will get as many admits as the floor can accept, patients will face plant out of bed despite having a working bed alarm, and that sweet old lady patient will become batcrap crazy, repeatedly call 911, and scream for help for seven hours straight. The universe is just waiting for a nurse to say the Q-word.

“That room.” Every nurse has an unlucky room on their floor. Something bad always happens in “that room.” I actually have two rooms that are “that room” on my floor. It’s a running joke that I can only take patients in 12 if they are already there when I arrive, but they aren’t allowed to admit a patient to the floor into room 12 and assign them to me. Why? Because they all end up in the ICU! It’s not my fault I swear, but it happens every time, one night it happened twice. Two different admits to the same room and the same nurse (me, of course) and they both ended up tubed and in the unit.  The other room, 23, is everyone’s “that room” because everyone has had a patient die in that room, the T.V. turns on by itself, and the room will ring the desk when it’s empty. It’s obvious that Room 12 is cursed and Room 23 is haunted.

“The full moon.”  I’m pretty sure this one was started by the first nurse to ever exist. Why? Because the night of the full moon promises hospital-wide crazy. This last year I worked the blood moon, which was also a full moon, and we had six overflow admits to the cardiac floor for GI bleeds and were transfusing so much blood we ran out of Y-tubing.  The whole hospital ran out of Y-tubing.  This one is true; I've seen it too many times to doubt it’s the real deal.

                           (This is terrifying. I wouldn't blame any nurse for flouncing this blog right now)

“The Frequent flyer.” We all have stories about that one patient that is always on the floor. It never fails someone will mention that person’s name and bam, you just got an admit and look who it is, that’s right, it’s the frequent flyer.

Why? Because this patient will run you ragged. You will attempt to satisfy every whim of the patient that probably knows more about the hospital than you do and isn't afraid to call the President to complain about the floor running out of lunchbox meals at 3 a.m.

“My mojo.” This one may just be me, but I have my own system and believe I am doomed to fail if it goes sideways for whatever reason.  I will always gather my own IV supplies when I agree to attempt a “hard stick,” even if you have supplies in the room. Why? It’s all about the process and getting my head in the game. It just works for me. I like to do everything the same way every time. If I don’t put my stethoscope in the same place at the end of every shift I will lose it forever! If a nurse has their way, and it works, back off.

There are other superstitions I've read about, opening a window after a patient passes away. The windows on my floor don’t open, or I would. Tying a knot in the right corner of the bed sheet of a dying patient…I could do this one. Taping atropine to the window of a bradycardic patient, this one is going into my routine. Even if you don’t believe in superstitions knock on wood, or Formica, for good luck all the other nurses will appreciate it.