Nurses week...

OK, I'm not sure exactly when it is, but it's coming up sometime. Let me start this post by saying that I have the greatest job in the world. I wouldn't trade it for anything in the world, and there is absolutely nothing else I'd rather do for a career. I've spent a lot of time in triage the past week, and I've done a lot of contemplating about human behavior. Anyone looking for a good observation of human behavior at it's finest, I have a suggestion. Go to your local emergency room and just sit somewhere in the back of the waiting room. You don't need to check in, you don't need to talk to anyone, just sit back and watch. You would be honestly amazed at what you will see. Apparently to most people, the rules of common courtesy, politeness, manners etc go out the window when you think you're sick. For those of you not familiar, let me explain. Triage is the system that we use in emergency rooms to evaluate patients. A nurse will see and evaluate the patient and assign an acuity based on the assessment. Most patients seem to think of the triage nurse as the magic key to unlock the door to get them seen by the almighty doctor. Thus, the amount of acting that is done to elaborate the stories is frequently quite comical. In the past week I have seen a woman down an entire 1lb bag of peanut m&m's in about 15 minutes while waiting to be seen for her nausea and vomiting. I've been yelled and, cursed at, swung at, spit at, and I even had a voodoo curse placed on me (I'm not exaggerating).


As nurses, we understand that everyone who comes to the emergency room thinks they are having an emergency. Each one thinks they are sick and/or dying. We have a different definition of sick than most people. Not all our patients understand that the kidney stone they are having, while extremely painful, is not an actual emergency. The thing is, the sprained ankle you have in one room is as important to that patient as the heart attack is to the patient next door. It is frustrating I'm sure to have to wait. What people don't understand is that airway trumps elbow pain. As nurses we have 4 other patients. In the emergency room it is commonplace to have one patient who is intubated, having and acute heart attack, or is otherwise actively dying. Part of our job is separating and prioritizing between the hurt, sick, really sick, circling the drain, and call the code patients. The fact that you have to wait 4 hours to be seen for your stomach pain does not mean that you are not sick, but you need to realize that there are people who are more sick than you. I had a father of a patient tell me once that he was grateful each time he got to wait in the emergency room, because there was one time when he didn't have to wait. His 3 year old son was having an asthma attack, and was blue by the time they ran him in the doors. He marvelled at how instantly there were people surrounding his son who was in the bed, intubated with 2 IV's started, labs drawn, meds given all within 15 minutes. It is fortunate that most people don't understand this. Let me assure you, if you are actually having an emergency, you will be treated immediately. And I hope that you never have to find that out.


Nurses are patient advocates, doctors eyes and ears. We are not cocktail waitresses, maids, or dirt underneath your shoe. We are professionals with college degrees. If you want two pillows a warm blanket and the lights dimmed, go to the hotel down the street. No one else goes to work with the understanding that they will not be able to sit, drink, eat, or pee for the next 12 hours ...again, not exaggerating. No one else goes to work where people think that it's okay to cough in your face without covering their mouth. I can't think of another field where college-educated professionals get hit on, grabbed, groped, yelled at, pushed and pulled in half, and still go back with a smile on their face the next day. I love my job. I love the stress, I love being on my feet running my behind off for 12 straight hours, I love that I'm so busy that i frequently don't have time to sit eat or pee for even a couple seconds. I'm writing this post not to complain, because as i said, I love my job and wouldn't trade it for anything. I've come to take it as a compliment when someone calls me a dirty name (see the next post).

Nurses week is funny to me. It's nice to be appreciated, but people go all out with the pink frilly fluffy stuff that irritates me to no end. I look at all the 'nurses care' crap and throw up in my mouth a little bit. This is why I work in the ER. You see, not all nurses are created equal. I would rather die than work labor and delivery. And I'm sure they feel the same way about the ER. I do care about my patients, but what you should care about more than the fact that I care is the fact that I am smart and good at my job. It might not take a lot of skill to fetch your pain pill, but what you don't see is that i can tell you the chemical structure of the pain medication, how it is absorbed and processsed and takes effect in your body. I can tell you every possible side effet, and the way to fix it should you have any kind of a bad reaction. This knowledge applies to your pain medicine and each and every drug that I give, including the more complex ACLS drugs that will start your heart again and keep it going. I have all this information in my head and will keep track of who has had how much of what medications, and could even tell you in the middle of running a code how much longer it will be before you can have more pain medicine. Of course I can't stop doing chest compressions to come tell you how much longer, but that doesn't mean I don't know, or that I've forgotten about you. I saw a tshirt once that perhaps sums it up the best. It said, 'I work in the ER, my job is to save your a**, not kiss it.' Now, to the point of me writing this post. You don't need to tell your nurses how wonderful they are and how much you appreciate all that they do, and think that they are the greatest things alive. If you feel so inclined, no one would stop you, but I would settle for some simple manners. Say please and thank you, cover your mouth, etc. Just be a normal person. Call me by my name. It's on my name tag, and I've told you 15 times. If you can't remember my name, do NOT holler 'NURSE!' down the hallway at the top of your lungs. Use your call light, or say a simple 'excuse me' or 'miss' or 'sir' as someone walks past and we will gladly attend to your needs. If you have to wait, this does not mean you do not have to be polite. We are not making you wait to punish you, or because we don't like you, rather we are attending to the needs of another patient who, like yourself, thinks that he is the only person in the department, or more likely, we are trying to stop the acute dying process on any one of our 40 other patients. Yelling and screaming and demanding things aren't going to get you treated any faster. We're used to the abuse, and it doesn't phase us one bit. It's kind of like when you were little and you asked your mom what she wanted for her birthday, and she said that she just wanted you and your siblings to get along, or you to clean your room. For nurses week, I don't need flowers and cards with pink hearts on them (gag). What I really want is one whole shift where people say please, thank you, and cover their mouths. Or even one whole shift where people don't argue with me about putting on a hospital gown, and complain about needing to have an IV started and blood drawn. I'll keep dreaming, but for those of you who come in contact with nurses --especially over nurses week, remember, we don't need a lot. A simple thank you means the world to us.