At Least You Never Have To Shoot a Jeep.....

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I ain't rich but Lord, I'm free,

Amarillo by morning,

Amarillo's where Ill be....

("Amarillo By Morning", George Strait)

Yep, I'm singing again....except I'm not going to Amarillo or anything.

(Although I surely would love to go to Galveston...) (Sometimes I think I'll NEVER get to go to Galveston....)

I'm not going to Amarillo or Galveston but my sister is coming from Dallas next week, hopefully with my niece in tow. My niece just started her Freshman Year at a good ole Texan university a couple of weeks ago and we're all anxious to hear how college is going. I think my niece is the greatest thing since sliced bread because she's one of the few people in the state who like my strangely-colored handknitted psychedelic socks. I'm currently working on a pair for her in Opal Tiger Rainforest (using Lorna's Laces for the cuff, and later the heels/toes.) I did "baby cables" for the ribbing.

Sigh....I need this knitting as relaxation. Because it's been another long week in the Road Nurse business here in the Wild Wild West--or, deep in the Heart of Texas. Man, that brings to mind another great George Straight song, doesn't it? It's the song that every Texan gets a tear in their eye when they hear--here it is:

The stars at night

are big and bright

Deep in the heart of Texas!!!

But don't forget, you have to sing this song just right. You have to do it the Texan Way---which is that you start each verse's line in a low voice but then YELL OUT the last word read loud-- and you also have to clap your hands at just the right beat before saying the line "Deep in the Heart of Texas!" like so:

The stars at NIGHT!

are big and BRIGHT! (clap clap clap CLAP!)

Deep in the heart of Texas!

And if you're really fired up, you'll STOMP your feet to the same beat that you're clapping. Get a whole bunch of Texans in a bar doing this and it'll bring the house down. And if it's done just right, every Texan in the place, young or old, will be bawling in 10 minutes, ready go out and fight the Alamo all over again.

(And if you really want to impress everybody, do a Rebel Yell real loud at the end: "YEEEEE-HAH!!!!!") (Stick with me when you come to visit Texas---I'll learn ya right!)

Anyhoo, it's been another long week. And I spent it doing my usual-- "riding the roads", seeing difficult patients, and gossiping on the cell phone with Belinda. When we gossip our favorite topic is usually about our "Gripe of the Moment", which means we will spend about an hour at a time, three or four times a day, moaning and groaning about whatever it is that we're pissed off about at the moment, which is usually the fact that we have too many patients to see, over too many miles, in too little time.

Belinda's calls to me usually start right after she's left her office, after getting her day's assignments, and usually go something like this, as was her call to me this morning: "You won't frigging belieeeeve what I've got to do today...."

I don't need to ask because I know she'll tell me as soon as she catches her breath.

"I've got to go draw blood on Ms. Tippercradle--and you know she hasn't GOT A DECENT VEIN IN HER ARMS---and THEN I've got to go ALL THE WAY OUT to that smelly McSwaney chicken farm to get some urine from Mr. McSwaney--and then I've got to go do wound care on Ms. Betterlock's legs....."

But I had her beat. Because I could top her misery.

"So what," I told her blandly. "I have to go admit a new patient to our services and GUESS WHO IT IS?"

"Who?" she asked.

"Somebody we used to have at your company when I still worked there," I teased.

"What? Who?"

"Somebody who gets pissed off at the drop of a hat over something stupid and then fires the home health nurses, remember? Somebody who once fired us three times in one month---but then would always call back every time and talk the Director into having us re-admit her just when I thought we'd gotten rid of her...."

I was drawing it out to make her curious.

"I give up. Who? Several people fired us over and over whenever they'd get pissed off! So who?? WHO???

I continued.

"You'll remember this person. She's somebody who had us so convinced that she was blind that we got Legal Services to help her get declared Legally Blind--and then we caught her hand-sewing beads onto her robe without glasses. Somebody who SWORE on the BIBLE that she couldn't see and yet I caught her peeling potatoes using a blunt apple-pearing knife with her left hand while she was watching 'Wheel of Fortune' on the TV--and SHE GUESSED THE PUZZLE correctly. Somebody who SWORE on HER GRANDCHILDREN'S HEADS that she was legally blind and couldn't drive a car--forcing us to have to go get her groceries all the time--and yet she stole a parking place from me one day while driving a CADILLAC in the dang Walmart parking lot!"

And then she remembered. "Oh MY GOD!" she cried. "Not HER!!!!! Not..... Lilly-Jean Blankenship??!!!!"

"Yep," I replied evenly. "T'is true. None other than the Queen of Mean, herself. The Patron Saint of Rudeness. The Princess of Sarcasm. The woman I voted 'Most Likely To Send Me Back To Drinking'...."

"GET OUT OF TOWN!" Belinda laughed. "Oh, Lord have mercy. Better you than me! We got rid of her when she fired us for the umpteenth time. But we thought she was picked up by Company X across town. We wondered whatever happened to her."

"Well, it seems that she fell down and broke her hip. Now she's out of the hospital and can't live on her own anymore. So she's checked into the retirement community on Jaseps Street. The Director over there gives all their home health patients to us, which is just as well because her former home health nurse company won't re-admit anyway. So we've inherited her."

Belinda had to agree that my day was thus worse than hers. And I did have to go over and admit that patient to our company's services. But I didn't feel that bad about having to do it, even though she was, true to form, rude as hell to me. I just did my duty and did the best I could. Because although I dread how she is going to treat us poor Road Nurses in the coming months, I had already vowed that I would be extremely kind to the patient and do my best in the future to give her the best nursing care that I can.

Because.... I have this belief. Which is that I believe.... that surely.....surely.... as God is in Heaven... that if I try to do my best with the sick, then SURELY it might wipe out some of the black marks against my character, right? Do you think? I mean, I'm always on the lookout for a loophole in my account with The Lord.

Because I think I have a lot of "black marks" against me. I've always been known as sort of the "Ace Ventura of Road Nurses". (Okay, of nurses in general.) (Okay, in general....) I'll admit--I've always been rather rebellious, wild, undisciplined, and er...a little crazy. So the way I figure it, perhaps by doing good deeds I can counter-act some of the other stuff. (At least I hope.... )

So my plan is to get some "credit for good behavior" with The Man Upstairs by doing things which come under the category of "Above and Beyond The Call of Duty". That way, when I finally knock on the Pearly Gates, and St. Peter is summoned to do the inevitable "accounting" whereby he adds up the positives and negatives, my positives will outweigh the bad, right?

We can only hope so.....

Did you hear the one about the three nurses who died and went to Heaven? They were waiting in line to get admitted through the Pearly Gates. St. Peter asked the first one: "What did you do that was good enough to get admitted to Heaven?" She replied: "I worked for 20 years in a nursing home, and so I helped humanity." St. Peter looked over her record and finally agreed, letting her into Heaven. Then he asked the second nurse the same question: "Whad di dyou do that was good enough to get admitted to Heaven?" She replied: "I'll have you know I worked for 20 years in an Emergency Room--and so I helped humanity." St. Peter had to agree with that, and so he let her in. Then he asked the third one the same question: "So what was it, sister? What did you do that was good enough to get into Heaven?" She replied: "I worked for a medical insurance company for 20 years, helping people with their insurance claims. I've definitely helped humanity." St. Peter thought about this for a minute--and then he finally said: "Okay, you've proved your point. You can enter Heaven......but your insurance plan says you can only stay for five days."

Anyway, being a Road Nurse has meant that I've had to put up with a lot of crap from my patients sometimes. Patients are human, of course, and that means they are not all "nice people". Some of them are mean, cruel, rude, and manipulating. Some of them treat nurses like we're Room Service at the Holiday Inn. Some of them treat us like slaves. Some of them treat us like idiots.

I don't really mind the mean and rude behaviors--because I simply chalk it up to someone who doesn't feel very well taking it out on me. And that's okay. In those cases I just bite the bullet and be as pleasant as I can, knowing that I'm doing it for a greater cause. I know that I am doing it for The Lord, or My Road Nurse Company, or The United States of America, or so that I can stay longer than five days in Heaven, whatever.

But I do get irritated when patients treat me like I'm an idiot. I mean, do they REALLY think I believe every one of their fibs and lies? I mean, sometimes I'm just dying to say COME ON, people!....I wasn't born yesterday! Give me a little credit for God's sakes. I would rather have a patient tell me an ugly truth than insult me by telling me a beautiful lie. I can respect the truth. Hell, I myself don't always take my blood pressure pill the way I'm supposed to. And I cheat on my diet, eating what I'm not supposed to eat--just like the next person, you know what I mean, here?

And speaking of patients treating me like an idiot, I've gotten pretty good at spotting a liar. I've been a nurse a long time and let me tell you, I can spot a lying patient from 15 yards away in the dark. I can tell from the first four words coming out of their mouth whether they're lying or not. And not only that, but I'm am absolute CHAMPION at keeping a straight face when a patient lies to me. Poker players have NOTHING on me. Because I have honed myself a fine talent for keeping a "concerned, trusting, expression" on my face to a fine degree NO MATTER WHAT ridiculous, untruthful, whopper of a lie a patient attempts to tell me. I have never once fell over backwards in astonishment, laughing hysterically while hollering: "GET THE HELL OUT OF TOWN, I DON'T BELIEVE THAT FOR ONE RED MINUTE! NEXT YOU'LL PROBABLY TRY TO SELL ME DRY LAND IN THE BAYOU!" to a lying patient---never once, I tell you.

In case you wonder what a nurse might REALLY be thinking when a patient lies, here's a few examples:

Patient: "Yes, Nurse, I've been taking my medicine EXACTLY like the doctor told me. The reason my blood pressure is high today is because I had three hushpuppies from Catfish King last night for my birthday dinner."

What I'm Really Thinking: Do I have "Stupid" stamped on my forehead? Your blood pressure has been elevated for the last 4 weeks. Your blood pressure is so damn high that you might as well be eating 7-course meals from Catfish King, Taco Bell, Kentucky Fried Chicken, and Baskin-Robbins 342 Flavors for breakfast, lunch, and dinner while you're smoking 8 packs of cigarrettes a day to boot!

Patient: "No, Nurse, I haven't cheated on my diabetic diet. I have only eaten what I'm supposed to."

What I'm Really Thinking: Do you think I'm BLIND and can't spot those two coconut creme pies sitting right there, big as you please, on your stovetop? Saran Wrap is SEE-THRU, Dumb Dora! And don't think I can't see the 'Chips Ahoy' bags on top of the cabinet, either. And I'll bet you a zillion bucks that there's a gigantic banana pudding in your frig.

Patient: "Now, I hope you nurses aren't going to get all grouchy about me forgetting to take that diuretic pill--I don't like taking it because it makes me have to go to the bathroom every 5 minutes. I'm thinking of calling the doctor to complain about you nagging me so much."

What I'm Really Thinking: I've already beaten you to the punch, baby. I have your doctor's number and I'm not afraid to use it. And I've already called and told him that you haven't been taking that damn water pill and that it's just a matter of time before you end up in the Emergency Room in cardiac failure. And his exact reponse to me was: "For God's sakes, she drives me NUTS every time she comes to the hospital--PUH LEEZE get that woman to take her goddamn diuretic pill so I don't get a dadblame ulcer!"

Patient: "I have no earthly IDEA why I fell in the middle of the night and sprained my ankle. I think I'm having dizzy spells from this blood pressure pill--yes, that's it--and maybe I just need a better walker so I don't stumble."

What I'm Really Thinking: I saw those three empty whiskey bottles in your trash can and I know damn well that you're drunk as a skunk every night! THAT's why you've fallen 4 times in the last year. A walker isn't going to help if you're so drunk you can't hold onto the durn thing--in fact, I think that the "Old Fart Police" ought to pull you over and arrest you for DRUNK WALKERING!

Speaking of drinking. I was completely CRACKED UP this week when I read in the newspaper that one of the "crimes" committed over the weekend was an arrest made by the police of a "person, under the influence of alcohol, who was riding a horse and howling at the moon." HEE HEE!!!! Drunk on a horse! Cracks me up.

Okay, I'll admit it...my smart-ass thinking immediately went to wondering what that particular crime should be called-- "Riding Under the Influence"???? And if one was convicted of that crime, then what would the penalty be?--mandatory attendance at a seminar given by an organization called Cowgirls Against Drunk Horseback-Riders?

Okay, okay--don't slap the bejeezus out of me--because I'm NOT making light of drunk driving and all that, okay? But I am laughing because it only PROVES MY POINT that not much has changed around here since the turn of the century. People here still wear cowboy clothes and ride on horseback a lot of the time. And I guess it only follows that if you're riding horses a lot that you might end up going to a bar on horseback. But since a horse is a vehicle, then a rider should be responsible and not "operate that vehicle" in a state of drunkenness, right?

Therefore, we can only hope that next time that guy goes out drinking on horseback that he will make sure that he first secures a....DESIGNATED RIDER, hee hee!!!!! (Sorry--couldn't resist.... okay, okay, I'll straighten up and fly right here...) (Before someone slaps the bejeezus out of me.....) (I HATE getting the bejeezus slapped out of me....)

Here's a horse friend of mine, named Beulah, but she's grouchy today. I told her the least she could do is smile when she gets her picture taken. She's pissed off because there hasn't been any rain in this part of Texas for a LONG TIME and so there's a shortage of lush green grass--it's all sparse, dried up, and yellow, as you can see from the pic. There's even been stories of people losing livestock because of the drought. (Let's pray for rain....)

Anyhoo, speaking of horses, guess what? To my delight, I found some pictures of what Road Nurses used to look like in the olden days! And you just won't believe it! My God, those women were AMAZONS! They are my NEW IDOLS! Because.....THEY RODE HORSES!

Yes, it's true. Here's the scoop:

It seems that the history of Road Nurses started back in the 20's when there were no Interstate Highways, Jeeps, or Dairy Queens to make Road Nursing in rural areas easy. Not only that, but there was also a complete lack of doctors in the wilderness. Most states had little or no medical resources outside the big city. So finally, individual states began forming "public health" nursing organizations to provide visiting nurses for people out in the farmlands, wild areas, and mountainous regions.

Many of these nurses were also midwives. They would go out into the countryside to deliver babies, immunize people against smallpox, and provide medical care to farmers, miners, ranchers, and whoever else had the bad luck to be located a zillion miles from the nearest doctor. Gradually, these organizations evolved into the home health nursing organizations we have today.

But I was FASCINATED when I read about one neat lady, Mary Breckinridge. And what I read about her made me vow NEVER to curse my Jeep, the weather, or the Interstate highway again. Here's why: In 1928, Mary Breckinridge began the Frontier Nursing Service in Kentucky. (Hey, a fellow southerner!) She wanted to provide visiting nurses for midwifery reasons. Because before that pre-natal care and childbirth assistance was primitive to zero in remote, rural areas. Little was known about modern medicine and there were absolutely no physicians nearby. Women usually had their babies while sitting on their husband's lap or on a chair with the bottom cut out.

Using her own money, Breckinridge formed the Frontier Nursing Service, in which trained nurses would travel to their patients on horseback. Her motto was that no home was too remote. The Frontier Nursing credo was that "if the father could come for the nurse, the nurse would get to the mother-- even if the terrain became to difficult for horses and the nurse had to finish the journey on foot". (Good Lord...)

And nobody was ever refused service for lack of money. History documents for the Frontier Nursing Service's finances state: "Although no needy person was ever refused service, she charged a minimum of $2.00 a year for general medical care and $50.00 for births -- payable in money, eggs, guns, whatever..."

(Woops, you can tell it was Kentucky and not Texas because there's no Texan in his right mind who'd part with a working gun....)

And apparently, this lady never called in sick. It is recorded that even when she was "crippled and in constant pain from a riding accident", she fiercely continued her work. As the FNS grew, Breckinridge became a non-stoppable fund raiser as she traveled the country speaking about the Kentucky mountains and the remarkable people who lived there. Breckinridge raised $6 million dollars in donations which she used to support her work and build the Frontier Nursing School of Midwifery in Wendover, Kentucky. Today, this school is one of the most respected midwifery schools in our country. Though Mary Breckinridge died in 1964, her story still lives on through the people she touched and their children and their children.

GOOLLLLEEEE GEEEE!!!!! I can't even imagine what life would have been like for those poor nurses who had to ride horses in order to see their patients. Here's a pic from the Frontier Nurses archives so we can imagine it a little bit:

Are they awesome or what? When I saw this picture I immediately thought of the last "group picture" for my company--and I was humbled beyond words. What a difference! Because for my last company picture, me and my igdity cohorts stood out on the street in freshly starched uniforms next to our air-conditioned SUV's, griping about gas prices. Makes me ashamed! I look at the picture of the Frontier Nurses and I just want to say: Yeehah and Giddy-up, gals!

Can you just imagine their day-to-day problems? Not only did they have to saddle up dusty, grouchy horses every morning and ride them through miles of God-Knows-What ground conditions and weather, but they had to perform all the daily care for those horses, like feeding them, watering them, clothing them, etc. (Maybe not "clothing" them, but at least "shoe-ing" them, okay?)

I mean, they really had it rough. And I have it so easy compared to them. For example, here's my "horse" (and it ain't named "Beulah".....)

(Nor does it respond to "Giddy-Up"....but it does respond to Valero Super Unleaded....)

And don't you just know that those poor horse-mounted nurses didn't have all the the nice, packaged, disposable supplies that Road Nurses carry nowadays. Heck, you should see what I carry on the road--it's all sorted out into various bags and tackle-boxes for ease in carrying:

The amount of medical supplies I carry in the back my Jeep today would rival a hospital emergency room: I have everything I need for starting IV's, drawing blood for labwork, transporting that blood to the hospital, performing complicated wound care, inserting and changing urinary catheters, puring liquid down feeding tubes, syringes for injections, stethoscopes, glucometers to check blood sugar, machines to check blood coaguation times, you name it.

Here's my blood-transport bag for when I draw somebody's blood for labwork and then have to take it to the hospital. Medicare regulations require that blood be transported in specific "Haz Mat" type containers. (I like the thing because it looks so "official"--and I can walk into hospitals pretending that I'm carrying organ-transplant donations--which makes me feel important....) (Okay, I'll admit here that I can't help it but I'm always tempted to "accidentally" drop the thing on the Emergency Room floor and yell: "DURN IT! I SURE HOPE THEM KIDNEYS ARE ALRIGHT IN THERE!!!!" )

But actually, I also need to mention that I'm never without the most IMPORTANT piece of equipment that was invented in the 21st century for Road Nurses, which are these:

Yep---a jumper cable. That's one thing about modern Road Nursing in a Jeep that's waaaay better than being on horseback. If it breaks down, there's alternatives. In the old days, they used to shoot the poor horses who finally wore out. But these days there's jumper cables.

Because you can't shoot a Jeep that's down, but you SURE AS HELL can jump the dang thing with a jumper cable, know what I mean?

(Where was I? Oh yes.....the Frontier Nurses on horseback.....)

Anyway, I'll bet those horseback-riding nurses in the 20's and 30's probably didn't have very many decent medical supplies. I would imagine that they had very little except for soap, water, string, and towels Which makes me feel like a WIMP for all the complaining and bitching I do to Belinda every day!!!!

So....I have made a VOW to stop griping about the little stuff I have to deal with. I have decided to try and be more like the Frontier Nurses. They are now my new IDOLS. I figure that it's the least I can do. So I am going to stop griping about the discomforts of being a Road Nurse in the 21st century. And I figure that if I act like a Frontier Nurse then it might garner me a few more points in my bid to get a "good rap sheet" at the Pearly Gates.

In fact, I already started reminding my buddies how lucky their lives are. Today, when Belinda called me on the cell phone for the umpteenth time to gripe again about having to go see that patient on the smelly chicken farm outside of town-- because she hates walking through the inevitable chicken poop-- I replied this time: "Aren't you glad you don't have to go out to that smelly chicken farm on horseback? Because then you'd get chicken poop in your horse's shoes as well as your own."

Later, my LVN was griping to me about how irritated she was to have to make two trips to the grocery store to pick up the correct brand of enema for one of her patients. I had a sage comment ready. "Be glad you didn't have to make two trips to the grocery store on horseback," I told her.

And later in the afternoon, the on-call LVN got mad because she found out at 5-minutes-to-closing that she was going to have to make an unexpected after-hours visit to see a patient in a town 18 miles away. "Just think," I told her as she angrily flounced around the office slamming things into her nursing bag for the trip, "If you were a Frontier Nurse you'd be leaving after dark for an 18-mile trip on horseback-- instead of in your Ford Explorer with its leather interior...."

"Would you just shut the hell up about being a nurse on horseback?" she exclaimed, flinging a urine specimen cup into her bag.

"Well, I DECLARE but SOMEBODY's sure in a Pure-Dee snit!" I huffed.

I comforted myself with the thought that maybe SOME PEOPLE don't care about spending more than 5 days in Heaven, but I SURE DO.....

Source of information/pictures on the Frontier Nursing Service: Wilkie, Katherine Elliot. Frontier Nurse: Mary Breckinridge. Frankfort: Frankfort Historical Society, 1992. Potter, Eugenia K. Kentucky Women Two Centuries of Indomitable Spirit and Vision. Louisville, Four Colour Imports, 1997. Breckinridge, Mary. Wide Neighborhoods: A Story of the Frontier Nursing Service. Lexington: University Press of Kentucky 1981. Frontier Nursing Service, Inc132 FNS Drive, Wendover, Kentucky 41775606-672-2317.

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