nursing is such bullshit

Top ten reasons why nursing is such complete bullshit:

1) In what other job are you expected be okay with being verbally abused?

2) In what other job, is the leadership so bad?

3) In what other job are you expected to go hours without a break and be okay with it?

4) In what other job are you asked to give dope to a junkie?

5) In what other job are you supposed to try and understand and empathize with someone who is threatening you?

6) In what other job do you get 2 dollars more an hour to be in charge of a place where peoples lives can be on the line?

7) In what other job are you physically, emotionally, mentally exhausted at the end of most days?

8) In what other job could you get a life threatening disease but are given no raise for a year?

9) In what other job are you exposed to junkies, criminals, sex offenders, psychotics, neurotics on a daily basis but you only hear from the management what you do forgot to chart some piece of bullshit?

10) In what other job do the mediocre advance to leadership positions? (see 2)

And that my friends is why nursing is such complete bullshit. The end.

Sincerely,

your friend
Madness
after a Monday 12 hour shift

that's me at the triage window

That's me at the triage window. The one who looks exhausted and a little bit peeved. I watch you walk down the hall towards me and, like it or not, I sum you up in seconds just by the way you carry yourself.

I watch you walk in and see how you approach me. Are you shuffling? Are you frantic? Do you have to stop to rest on the way? When you get to the window do you go into excruciating detail going back five years about why you are here? Do I have to pull what's wrong with you out of you? Are you hanging over the desk in a dramatic fashion? Are you pale, sweating? Short of breath? Did you come alone? Do you come with a posse? Do you immediately ask me how long the wait is? Do I need to run you right back? Are you accompanied by the police? In handcuffs?

I will have a pretty good sense of the seriousness of your condition and what kind of person you are before you even come through the triage door. After about a year in ER you are pretty much an expert on the human race and all its quirks and personalities. I can go into a room and take one look at you and sum up how sick you really are.

You might think that sounds unfair. I am not giving you a chance. Its reality. I have to be able to sum you up quickly. If I can't tell if you are real or fake, a wimp or really sick, I'm not doing my job. I am the first one to see you. I have to develop an instinct for people. If I don't you might die. If I assess you in your room and you are in trouble and I don't intervene immediately or call the doctor, you probably going to go down the toilet.

When people come to the hospital, often they concentrate on the doctor: when can I see the doctor? Where is the doctor? You really should be concentrating on me because I'm the one who will prevent you or your loved one from deteriorating. I'm the one who spends the time with you, monitors you, trusts my gut when dealing with you. Your life is really in my hands. Especially if you really have an emergency.

madness: personification of evil

Dere is people out dere who be thinkin' dat madness is a cynic, a real bitch. I don' give dose drug seekers the benefit of the doubt and all dat. I am a hard, burned out old witch of a nurse....that goes without sayin', but in my defense...I have been in the ER for many a year. My job is similar to a cops, only I have to keep my mouth shut. The cop can tell your sorry ass to shut the f--- up, I can't. I could but I would lose my job. Need the job, so don't. Cops have guns, madness don'. But we do deal with all the same people. From one end of the spectrum to another.

So excuse me if I have developed jus' a little bit of suspicion, caution, you gotta prove you ain' oneadose drug seekin' idiots attitude. I, along with many of my nurse pals, have been burned. Big.

What folks don' understand about drug seekers is that they are ADDICTS. They will do anything to get the fix. They will lie, fake, tell whoppin' stories...they are really pretty dangerous people. I have seen them get out of control when they don't get what they want. Suddenly that back pain is out the window and they are fightin' security on the floor.

I have seen drug seekers tell MAJOR stories that we all believed. What they are willing to do for the fix would floor you. So check your attitude about me not carin', giving the benefit of the doubt, etc. I have big time intuition about people. I can spot a faker at 50 paces with 99.9% accuracy. Whether you like it or not.

They waste my time, your money. (yeah, dats right mr/mrs taxpayer your money - you don't think THEY are payin' do ya?)Picture this scenario: your mom is having a heart attack and you bring her to us. I can't help her right away because I am down the hall dealing with the out of control drug seeker....thats my job in a nutshell.

runaway train, never going back

Here's an interesting development: Some states are passing limits on the number of inpatient days per year for adults on medicaid. It ranges from 10 days in Hawaii to a new proposal of 25 days in Arizona. This is all in an effort to decrease cost.

Lets say your patient has an illness that requires more than 10-25 days...or that your patient comes to the ER and needs to be admitted but has used up their yearly inpatient days...then what? They will be admitted to the hospital because the hospital is not going to throw them out. For liability reasons, for EMTALA reasons, they will get the care they need and the hospital will absorb the cost.

These changes, along with the coming 30% cut in reimbursement of physician fees come 2012, are going to have a dramatic effect on hospitals bottom line. I really wonder how the government and our country expects hospitals and doctors to deal with all of this. We will see more hospitals closing, more doctors will refuse medicare/medicaid patients.

At a time when medicare and JCAHO are requiring more and more of hospitals, reimburnsement keeps going down. It doesn't make sense. People want sophisticated treatment and the latest technology, but the money is not there to pay for it. Health care in this country is like a runaway train that gets closer and closer to crashing. Like most problems, we will no doubt wait until the crash happens.

Four Loko is muy loco

Four loko. I have vaguely heard of it. I thought it had been banned.

It is an alcoholic energy drink. Described on one web site as: "Legalized cocaine in a can. If you consume Four Lokos you can expect to encounter the same results typically associated with snorting a small mountain of cocaine".

It contained caffeine and alcohol, apparently not a good combo. If people drank 2-3 cans, blackouts are common. People end up in jail and ERs a lot. It was popular with college students. Why wouldn't it be? As of 2011 caffeine was removed from it because of all the problems associated with the combination of ingredients.

Why am I telling you this? It is all part of the Madness Emergency Room Information Initiative. Har. Actually one of my patients told me they had been drinking Four Lokos to dry and relieve pain they were having today. Guess it didn't work...