Monday, 16 February 2015

Nurses

Who makes your bed, gets you water when you're thirsty, wipes your ass after you poop, cleans up your vomit, gets you medicine when you're feeling sick, and cares for you unconditionally?  No, I'm not talking about your mother (who hopefully does all those things too, only she doesn't get paid for it).  Come on, have you not been paying attention?  The title is a dead giveaway!  Didn't you read it?

YES, NURSES.  Well done, you.

These vastly under-appreciated (and generally underpaid) people are always on the front lines of healthcare.  Doctors, surgeons especially, do not spend every waking moment in the hospital, so when we aren't there we rely on the nurses to be our eyes and ears, seeing things we may not, listening to patients' complaints, and calling us when something seems awry.  DadBastard (who, as you may recall, was a surgeon himself) taught me one very important lesson just before I started medical school, the same lesson his father, GrandpaBastard (also a physician), taught him:
Be nice to the nurses, because they can be your best friend or your worst enemy.
Sager words were never spoken.  However, as important as they are, not every nurse is worth his/her weight in gold (yes, some nurses are men).  It is relatively easy to differentiate a Good One from a Bad One, one you can trust versus one you wouldn't want caring for your hamster, if you had a hamster of course.  But who the hell wants a hamster anyway?  I guess they're sort of cute, but cats are far better pets.  If Mrs. Bastard weren't deathly allergic to them, my theoretical cat would totally eat your stupid hamster.

Er, sorry about that stupid non sequitur.  Those responsible have been sacked.

Since this blog is about stupid people and stupid things and stupid mistakes, and since I've already verbally abused doctors, patients, lawyers, paramedics, police officers, and myself (repeatedly), it only stands to reason that, despite my esteem for them, I can't just give a free pass to nurses.

Especially nurses like Thelma (not her real name©). 

When I first started my training, I heard from several of my senior colleagues (who had suffered through working with her for several years) that Thelma wasn't exactly the sharpest scalpel in the box.  They told me that she needed strict, thorough instructions, and that if her instructions were explicit enough, they would be followed.  No more, no less.  Thelma was that literal.  Literally.  She was utterly literally literal.  One night around midnight just as I was finishing up a last-minute assignment, my pager beeped.  It was Thelma, who wasnted to tell me the results of one of my patient's blood tests.  All the numbers came back normal, though the bilirubin (a normal product of red blood cell breakdown and component of bile) level was low.  Though it was early in my training, even I knew that high bilirubin is a cause for concern, but low bilirubin is completely meaningless.  Having been a nurse for over 20 years, Thelma should have known this, but she made sure to emphasise the low bilirubin several times.  So, not yet knowing Thelma's literalness, I decided to have a little fun.  I jokingly told her to give the patient 2 grams of bilirubin.  Ha!  Hilarious, right?

"Ok," she said and hung up.

Wha . . . wait . . . she did know I was joking, right?  There's no such thing as giving bilirubin.  She's been a nurse for 20 years, so she knows that . . . doesn't she?  As I mulled over whether or not I should call her back, my pager went off again.  It was Thelma calling me back, asking if I wanted to give the patient the bilirubin orally or through the IV.

Seriously.

A few months (and several more complaints) later, Thelma struck again, this time with Edward (not his real name©), one of my fellow trainees.  Edward was a bit, oh let's just say odd, and by 'odd' I mean completely loony-tunes whackadoodle barmy fucked-in-the-head batshit crazy.  There's a very strong chance (riiiight around a 100% probability) that he did not finish his training with us, partially (read: almost entirely) because of this episode.

One of our surgical patients, who had just had a major 6-hour abdominal surgery earlier that day, was having heartburn, and Thelma called Edward to let him know.  The patient couldn't take anything by mouth because he still had a nasogastric tube suctioning out his stomach, so Thelma needed an IV medicine.  Edward took a page out of the What The Fuck Were You Thinking textbook of surgery and told Thelma, completely sincerely, to give the patient hot tea through his nasogastric tube until he felt better.

"Ok," she said and hung up.

Just take a minute to let that sink in.  I'll wait.

Now before you think Edward was just joking and having fun at Thelma's expense (like I had been), I assure you he was not.  In the investigation that followed, he revealed that he had fully intended for Thelma give the tea, because , um, Edward reasons.  The worst part (or best part, depending on how deranged your sense of humour is) to come out of this was the actual, real, I-swear-I-couldn't-even-make-this-shit-up clarification phone call Thelma made to Edward not one minute after she hung up with him:

"Excuse me Dr. Edward, you said to give the patient 'hot tea.'  How hot?"

13 comments:

  1. Oh Jesus. What happened to the patient?

    Please tell me Thelma didn't continue working there. That's not being literal, that's being "I am making sure I always have someone else to blame and cover my own ass if things go wrong"

    ReplyDelete
  2. This brings to mind an episode where I was called in to attempt basic fixing on a Xerox machine that had apparently decided it loved paper and did not want to let any go - which result in a 100% jam rate.
    after trying fruitlessly to explain to it that it was supposed to release the photocopies it made to seek their fortune, it persisted in sticking them to its imaging drum. finally, seeing the futility of attempting to reason with it, I told the person who had asked me for help, "It looks like the machine is out of whack, you'll have to call the repair service and order some more."
    there was about a 30 second mental progression from blind literal acceptance to the realization that I had deliberately fired off a non-sequitur.

    ReplyDelete
  3. I hated being the person who could decipher our copy machines moods. Almost as much as I hated pouring toner into it and getting dry ink on my blouses (5'2 and had to stand on a box to pour it in). One time a new employee, hired for her bra size not her brains asked me how I was going to fix it before they called the repair guys...she had immediate things to copy.... this was in the days before decent printers. I told her to kick it where the cord went in wait 5 minutes and turn it on. If it didn't work, repeat till it did. For all I know she's still there waiting.........

    ReplyDelete
  4. also, if you ever want to go out and have a fun - but mildly disturbing - time, go out with a group of ER nurses.

    ReplyDelete
  5. I recently had an adrenalectomy and spent about three days in the hospital. While I was there, one of the many shots they gave me a couple of times a day was heparin. The female nurses each grabbed a layer of fat on the side of my stomach, massaged it a little bit, and injected. It stung a little, but I could deal with it. Day 3 I had a male nurse with the name of a Greek god who walked up behind me and without warning, jabbed me in the back of the shoulder with the heparin. I screamed. It was like fire. He said, "Yeah, that one feels like a wasp sting. That's why I didn't warn you." Next time he came for shots, I told him I'd inject myself.

    I have had some wonderful male nurses. He was just not one of them.

    ReplyDelete
  6. Another fine post, another firm erection. I tip my "hat" to you fine sir!

    ReplyDelete
    Replies
    1. If you shove something weird up your ass, you might just get to meet him.

      Delete
    2. This is just getting weird...

      Delete
  7. Hey Doc, I would say I am firmly pro-vaccination, but have a question about your vaccination beliefs. In the article below, parents describe the negative effects vaccines have had on their children and how vaccines can, extremely rarely, have life altering side effects. Do you think there should be medical exceptions for vaccines? I assume you disagree with religious/personal exemptions, but do you think people should be forced by the government to vaccinate their children? Should children not be allowed in government programs, such as school, if not vaccinated?

    I appreciate your pro-vaccination efforts on the internet because the return of vaccine preventable diseases does not come from anti-vaccination idiots, but from masses of people who choose ignore/believe them.

    https://www.yahoo.com/parenting/parents-of-vaccine-injured-children-speak-out-110904439577.html

    ReplyDelete
    Replies
    1. I'm going to say on his behalf - yes, if there is a known problem with a person receiving a vaccine, the person should not receive that particular vaccine. this is why everybody ELSE should be vaccinated: so that those who cannot be vaccinated because of medical reasons will not be at as much risk of coming into contact with an infectious person.

      Delete
    2. Medical exceptions should be the only acceptable type. Governments mandate all kinds of things on their people "for their own good" -

      -motorcycle helmets
      -seat belts
      -safety testing on cars
      -child safety seats
      -speed limits
      -banning illegal drugs
      -making prescription narcotics difficult to obtain

      Vaccines belong on that list.

      Delete

If you post spam or advertisements, I will hunt you down and eliminate you.

Comments may be moderated. Trolls will be deleted, and off-topic comments will not be approved.

Web-hosted images may be included thusly: [im]image url here[/im]. Maybe. I'm testing it.