Sunday, December 31, 2006

Podunkgate...

*
*
Some caught a freight, some caught a plane
Find the sunshine, leave the rain
T*
They said this town's a waste of time
I guess they're right, it's wastin' mine
S*
Some gotta win, some gotta lose
Good time Charlie's got the blues.... *
(*
(Danny O'Keefe, "Good Time Charlie's Got the Blues") *
*
I have the blues. In fact, I am so blue that I can't even think of a single joke--and that means it's really bad. Because I can usually make light of any desperate situation---I've always been able to do that.
No matter what calamity has ever befallen me, I was always like The Unsinkable Molly Brown singing "I Ain't Down Yet". Hell, I could always whistle in a storm, sing during an earthquake, dance a jig during a disaster.... *
B*
But not this time. *
L*
Lord, God, I haven't been this depressed in a very long time. And I
don't quite know what to do about it. I really don't. My coping skills have failed me. *
A*
And so what I've been doing for most of this weekend is driving around in a stupor, methodically seeing my patients since I'm the "on-call" nurse this weekend, and staring numbly at the scenery that goes by as I drive. I'm hoping that staring at beautiful scenery will give me some comfort. I need something to dull the ache. I need to eye something which will put pleasant thoughts into my mind---in order to avoid the invevitable thoughts of WHY, WHY, WHY this terrible thing came to be.... *
B*
Because my world has been shattered. Shattered terribly. The rug has been literally pulled out from under me, and I can't believe it. I never saw it coming. And I don't know what to do about the whole thing. And so I guess I might as well get it out and tell you what it is, but a short sentence seems so inadequate to describe the whole situation....but here it is: *
M*
My boss, Lu-Lu, was fired by her family. They said they fired her for what they term "a host of unacceptable behaviors". *
A*
And I am in shock.
*
A*
And so, I drive. And I see my patients. I have two "daily" patients to see this holiday weekend. One is a woman who needs an IV antibiotic every day through a triple-lumen IV catheter in her jugular vein, as well as complicated wound care to infected wounds all over her body. The other patient is also a wound care patient, a diabetic woman who is facing amputation of part of her foot if the infected wound on a toe-amputation site does not heal. I also had to go see a man who just got out of the hospital after being treated for chest pain and a blood clot in his leg. I am trying to keep up a cheerful mood for these patients' sakes---but it's difficult.
*

*

With Lu-Lu gone, I am the only RN left in our office. And I am an RN in shock, since Lu-Lu was not only my boss, but a friend of mine. The rest of our staff consists of several LVN's, two home-health aides, and a secretary---and they are all in shock, too. For right now I am temporarily in charge of the office until Lu-Lu's aunt and uncle, the owners of our company, come back from their holiday in Las Vegas and decide how to organize the office. I don't know what they're going to do or who they're going to put in charge. I'm not sure what I'd do if they asked me to take over as manager, because to tell you the truth, I feel that my strengths are better used in the field rather than in an administrative capacity. *

I haven't been sleeping well. For two days I didn't sleep at all---in fact, I thought I was going to go crazy from lack of sleep. Finally, last night, I was able to sleep---but it was lousy sleep. *

This is what happened:

Lu-Lu's always been a "wild-card", but then, most of us Road Nurses are somewhat wild. She was typical of most Road Nurses in that she was a spirited, unconventional, passionate individual, with a great love for her patients and a quick wit which served her well in the unpredictable,haphazard life of a Road Nurse. *

She was also a quirky, funny individual, with a great sense of humor. And she had a keen intelligence, mixed with moxie and organizational skills, which enabled her to quickly climb the hierarchy ladder of whichever nursing company she worked for. Her management and administrative abilities earned her the admiration of her entrepreneurial aunt and uncle, who gave her the job as Manager in one of the branch offices of their Road Nurse company--- with eventual plans to include her as a full partner in the business.

The future looked very bright for Lu-Lu. She had EVERYTHING a girl could want---looks, brains, intelligence, and a secure place in the family business. I*

I knew Lu-Lu from a previous Road Nurse company, where she had also been my boss. Shortly after setting up her office in this current Road Nurse company, she had recruited me away from our former company. We had always worked together well. I felt as if I knew her as well as I know anybody in Podunk.

Lu-Lu was a tough boss to work for as she expected her nurses to be on top of their game at all times. Lu-Lu was an extremely competent nurse, and she accepted no excuses for poor performance---she would quickly call you on any laziness or sloppy workmanship. But she also had a "soft spot" for her employees, and was always understanding about road fatigue, sickness, or those twists in life which might cause a person to need a "mental health day" here or there. Lu-Lu also paid well. Lu-Lu was notorious for paying her nurses generously, paying them more than they could get anywhere else in town, and she was never stingy about raises. I*

In short, Lu-Lu was an "okay gal" to work for. Don't get me wrong, she had her faults just like everybody else, faults which could sometimes drive me crazy. But even with those faults, she certainly wasn't a bad boss---actually, she was a lot nicer, more fair, and much more pleasant, than most bosses I've had. She was actually a decent enough boss that I considered myself lucky to work for her. A*

And then.... H*

Her aunt and uncle reported that they had discovered.... some things. Apparently, according to them, Lu-Lu had done some things which were totally unacceptable to them within the framework of the business agreement she had made with them--- as to the way she ran the office, the way she conducted the finances, her behaviors on and off the job, and the way she conducted her personal life in relation to the company's image. And they considered it of such a serious nature that they fired her.

Without notice.

Effective Immediately.

*

And believe me, it has turned into a great scandal here in Podunk. The gossip is so rampant and virulent that Lu-Lu has gone into hiding. As for myself, I have avoided Walmart because I don't want to be in a position for anybody to ask me about the whole thing. I really don't know what to say. I don't want to say anything because I believe that a person is innocent until proven guilty--and I don't know whether the accusations are true or not. I*

I won't go into detail here about why they accused her of such things, but I will simply say that I did not know or even suspect about most of their concerns. I was completely surprised when the whole thing happened. In fact, you could have knocked me over with a feather. And furthermore, ever since it happened, I am left feeling a complete flood of emotions--confusion, anger, betrayal, bewilderment, disbelief, sadness, and shock. T*

They accused her of lying about finances, lying about her work hours and the office budget, "drug use" on and off the job, "moral misconduct" with two married doctors in town, and gross misuse of the office secretary's work time (using the secretary's time for her own personal errands instead of company duties). E*

Everything (or rather, the final incident) happened Thursday while I was out seeing patients. There had actually been some previous unpleasant incidents which had built up to the final climax---things which had simply looked to us to be family arguments that we really didn't want to get involved with--- but the long and the short of it is that it all ended Thursday in some sort of a telephone call "show-down" between Lu-Lu and the owners. *

And after that phone call, Lu-Lu had apparently lost her temper and trashed our office (to the bewilderment of the hapless secretary)--- and then she had loaded her personal effects into her vehicle and left. I haven't seen her since, nor has she answered any calls to her cell phone. W*

When I arrived back at the office, I found the forlorn secretary somberly cleaning up the mess Lu-Lu had made, sighing greatly with each effort. I asked her what had happened and she explained the sequence of events. "And then she trashed the office," the secretary stated as she swept up a broken flower vase. "We're probably lucky she didn't have her pistol with her. And then after she finished throwing everything around the room, she made me type up her resignation letter. And I typed it just like she told me, F-words and all. Do you think I should leave in all those F-words?"

Later, the owners each called me on my cell phone and briefly stated the situation. They also explained that they "valued me" and wanted me to stay with the company. I told them I would. And then they promised that they would fix everything "back to normal" when they returned from their vacation in Las Vegas. A*

After that, some men arrived to change the locks on our offices. I was given my new set of keys. And then our Public Relations Director arrived to sit guard duty for the rest of the day, in case Lu-Lu returned to cause more mischief. But I knew she wouldn't come back--she'd already made her point. A*

And now I am on-call for the weekend, doing my duties, wondering what in the hell happened. Wondering why I never saw it coming. And wondering how in the hell I'm going to get out of this horrible mood. Even Belinda has not been able to console me. I have talked with her daily, wailing about my depressed mood, and she has been a good friend, letting me vent while she listens patiently.

Belinda even admitted to me that she knew of some of the story, gleaned from town gossip, but that she hadn't wanted to mention any of it because she didn't want to upset me, knowing that I was a loyal employee to Lu-Lu.

Actually, this isn't all that unusual. Belinda has accused me of being "naive" before, and states that I'm like an "ostrich with my head in the sand". I don't know. I really don't know. Like I said---I didn't realize all this stuff was being talked about around me.

Ah well, I guess I must post this blog entry now--- and get back to my on-call duties. In fact, while I was writing this post, one of my patients called me in distress. She had just returned from a holiday vacation in Austin, where she'd fallen ill. She stated that she hadn't wanted to see a doctor in Austin because she didn't want to be "sick in a strange town" ---and so she'd made her husband drive her back home to South Podunk just as fast as he could. She told me that she "felt terrible", her legs were "swelling up", she was short of breath, she couldn't breathe well "layin' down", and she was "coughing and spitting stuff up".

This list of symptoms caused a cold wave of panic to wash over me---as they could be signs of congestive heart failure or pneumonia--- or both. I told her that she needed IMMEDIATE evaluation by a doctor, and I urged her to let me call the paramedics. She wouldn't allow this but did agree to ask her husband to drive her to a nearby country hospital, where there is an emergency room. I spoke with her husband, asking him to be sure and take her medications with them to the ER so that the doctor there would know what she is on, and then I called the ER myself, to give them a verbal "report" on the patient. She is on her way to the ER at this moment....

I will call the ER later, to check on her progress and see if there is anything else I can do to help.

Maybe working and keeping busy will keep my mind occupied so that I don't dwell too much on the sorrow and pain I'm feeling. It also helps me to knit. Knitting soothes and relaxes me. I'm currently knitting a square, pschedelic baby blanket for Belinda's future baby, using various colors of Debbie Bliss Cashmerino Aran that I picked up while in Dallas (at The Woolie Ewe--love that place...)

**

Update, 10:00 pm: The patient who was taken to the Emergency Room did get admitted to the hospital. Thankfully, she is stable and doing well.

*

Wednesday, December 27, 2006

An Announcement from the Message Goat...

Ahem?
A*
Ahem, ladies and gentlemen, this is your Message Goat speaking...
I*
I have a message from Bohemian Road Nurse. She wishes me to tell you that she was all set to start blogging away again, after returning from her Christmas in Dallas, but she was held up in this endeavor tonight by her exhaustion and stress-level.... because...
*
Alas, there is Trouble In Podunk....
I*
It seems that there is a nasty family squabble brewing within the upper management of the Road Nurse Company, within the Owners' large family. There are several issues at play including broken contracts, a general nursing shortage, broken promises, stern/chauvinistic Owners, tittybaby rookies, tattletale secretaries, salary arguments, and other various & sundry things found in TV Soap Operas such as "As The Stomach Turns" , "The Young & The Chestless" , and "All My Nurses" .
(*
(And also like a couple of movies such as "Gone With The Catheter" , "Raiders of the Lost Haz-Mat Bag" , and "A Funny Thing Happened On The Way To The Dairy Queen"....)
B*
Bohemian Road Nurse is hoping to stay out of the whole mess as she is not related to the Owners' family and just wants to get through her days and collect her paycheck as peacefully as possible---and also due to the fact that she is "on-call" and really couldn't care less about a dadburn thing except her overwhelming need for at least 6 hours of sleep per night.
T*
Thus, Bohemian Road Nurse has decided to keep her head low and just try and ride the whole thing out as best as she can, to see what happens.....
*
And also, Ladies and Gentlemen---(and you didn't hear it from the Message Goat, ok?)--- today the Bohemian Road Nurse was overheard saying:*
*
"Dammit, this is one of those times that I wish I'd been a dang Kilgore Rangerette instead of a Road Nurse---because I'll just bet that the dang Kilgore Rangerettes have much easier lives than those of Road Nurses...."
T*
The Message Goat would like to say here that he is not exactly sure about what the life of a Dang Kilgore Rangerette entails, but he does advise everyone to adopt a "wait and see" attitude about this whole situation in the meantime....
S*
Stay tuned......
*

Thursday, December 21, 2006

My Christmas Card to You....

*
To: My Beloved Readers.....
*
From: The Bohemian Road Nurse..... *
M*
Message: I'm off to Dallas for 3 days with my family. I will return to Podunk on Christmas Day, to go "on-call" the day after Christmas. But please know that I wish you and your families the most Happiest Holiday Season in the whole wide world!....May all of your fondest hopes and dreams come true!....You are all in my constant thoughts and prayers at this special time of the year.... * *
M*
Merry Christmas Everybody!!!!!!! *
*

Sunday, December 17, 2006

They call me Eddie Haskell.....

*
When it's Christmas time in Texas,
It's a very special time for me,
In Texas we'll be swingin'
around the Christmas tree,
Dancin' to a Christmas melody,
*
When it's Christmas time in Texas,
It might look just like a summer day,
There may not be snow in San Antonio,
But it's a Texas Christmas to me...
*
("All I Want For Christmas is You",
Vince Vance & Valiants)
*
It started out as (and continued to be) a terrible week. But I have to admit that everything ended up pretty well in the end. The problem was that I had to go through the bad to get to the good....
*
*
And because it was such a crummy week, I was extremely grouchy. I had to repeatedly ask my co-workers to forgive my crabbiness. But I thought I had good reasons to be crabby. First of all we're very short-staffed because one of our nurses quit, dammit. (Another one bites the dust---turnover is high in the Road Nursing world....) What's worse is that we were already shorthanded BEFORE that nurse quit because one of our LVN's is on maternity leave till January 8.
* *
Secondly, many of our patients are sick with the crud. There is a nasty upper respiratory virus going around and it popped up to strike many of our patients at the same time, giving them all a bad cold--- which worries us Road Nurses because many of these people have pretty ineffective immune systems, and a simple cold for them could very well develop into worse things like bronchitis and pneumonia. And the fact that so many of our patients caught this virus meant that our company had to add a whole lot of extra patient visits onto our already-packed visit schedule in order to keep a close eye on those who are ill. *
*
And then poor Lu-Lu caught the same crud that's going around. On Monday she started sniffling, coughing, and dragging around like the walking dead. At 4:00 pm I told her to go home and take Nyquil or something, but she continued to get worse. By that night she was so deathly ill that the doctor actually left his ranch to meet her at his office at around 8pm to give her a shot. And he told her to stay in bed for a few days. The added loss of Lu-Lu being down REALLY hurt our staffing numbers. And so those of us still left standing had to run our butts off all week long to hold the fort down. And it was exhausting. By the end of the week I'll bet that I had driven a total of 8 zillion miles to see about 3 zillion patients.
*
I washed my hands so many times that both they and the Jeep began to reek of my anti-bacterial hand cleanser---because I placed myself on a diligent crusade to avoid catching that nasty virus myself.
* In fa*
In fact, as the week wore on, I developed an extreme anxiety that me or Jane-Anne would catch the same virus everybody else had and get sick ourselves, causing the need for us to be forced to take a day off to recuperate--- creating further disaster in our available staff numbers. I even telephoned Lu-Lu to mention this anxiety to her. *
*
"Don't be a worry-wart," she told me, blowing her nose loudly into my ear. "I've got the whole thing worked out with Doc Jenkins. I told him that we're so short-staffed that we simply can't afford for anybody else to get sick. So he said that if you or any of the other nurses start feeling bad, that he'll give you a shot or something to fix you up good enough to be 'road-worthy'." *
*
"What did he put in that shot he gave you?" I asked. *
*
"I have no idea," she replied. "But it hurt like hell. Anyway, if you start feeling bad, then get your butt over there. He said that you don't even have to check in at the front desk or pay for the visit--- just go in through the back door and he'll give you the shot and as many free samples of cough drops, antihistamines, decongestants, or antibiotics that you need." *
*
Although I appreciate our good ole doctor's kindness, I hate going over there. He's a wonderful doctor and all, but he always finds a reason to give me a damn shot ever single time I go over there. And I hate needles. And also, I am patholigically modest---and I hate fighting with his sassy nurse over the fact that I don't want to put on that damn gown. And for that matter, I also hate having to set my urine sample cup down on the same counter top as the rest of the patients....because letting all those people see my pee is embarassing---since they're the same people I go see as my own patients every day! *
T*
This is a small town---and so everybody goes to the same doctors. And so whenever I go to Doc Jenkins I have to trek up and down the halls of his clinic, half nekkid in that dang gown, right next to the same exact people that I see as a nurse every dang day of my life---and sometimes their dogs! Because Doc Jenkins doesn't mind it if some of his patients absolutely insist on bringing their stupid dogs with them when they come for an office visit. One time I had to wait for my chest X-ray in the same waiting room as a little asshole weenie-dog who had bitten me once when I'd gone on a nurse visit to see his owner. *
A*
And Doc Jenkins can lecture something awful when he thinks you're not following his orders. The last time I was there, he burst into my examining room and hollered out: "Bohemian, didn't I put both you and Lu-Lu on Toprol XL? I want you to come down to my office right now and talk to me about your blood pressure!", and as he dragged me down the hall with my gown's tails flapping behind me I heard a satisfied voice coming from a nearby examining room saying: "I hope he tells her the same scary thing that she always tells me---that if she lets her stupid blood pressure get sky high it will blow her brain or heart to smithereens!" *
S*
So to tell you the truth, I'd really rather have had a "doctor's note" excusing me from working altogether this week, rather than antibiotics, if you know what I mean. Because I'm telling you, this past week was absolute murder. T*
T*
The thing about me is that whenever I get that stressed out, I can sometimes get a little crabby. And I can assure you that I was extremely crabby this week. And it didn't help that I kept getting into frustrating predicaments with demanding patients and snippy medical personnel. There must have been a dark star over the medical community of Podunk this week---because almost every other medical person I talked to was just as crabby and overworked as I was, and they freely vented their frustrations on me, despite the fact that I was equally frustrated and overworked. I*
In f*
In fact, by the end of this week, I was so aggravated at some people that I wanted to snatch them bald. (*
(Hic*
(Hickese translation: The expression "to snatch somebody bald" is a Texan expression for what you want to do to somebody who really pisses you off. And it's just as simple as it sounds---it means that you want to reach out and grab a handful of the offending person's hair and just YANK the hell out of it, just for the pure satisfaction of doing it...) B*
But *
But besides entertaining satisfying fantasies of snatching people bald, I also have an additional coping skill for crabbiness. Since I don't want to get arrested for assaulting somebody's hair, and also the fact that it may not be healthy for my career to speak my mind openly about my exasperation with irritating people , I sometimes find it necessary to employ the "Eddie Haskell maneuver". (People who know me well can spot it instantly---and it frightens them to death.)
*

T*

The "Eddie Haskell maneuver" is where I say one thing while I'm thinking another, a la Eddie Haskell's dual-natured behavior in that ancient TV show, "Leave it to Beaver". Have you ever seen that show and watched Eddie Haskell in action? He was a total creep but would pretend to be a perfect angel around Wally and The Beaver's parents, smiling sweetly and behaving like a perfect gentleman, usually saying something completely ass-kissing to Mrs. Cleaver like "That's a lovely dress you're wearing, Mrs. Cleaver". But as soon as the parents weren't around, he'd revert back to his obnoxious and rude self. "G*

"Good morning, Mrs. Cleaver, that's a lovely dress you're wearing!" he'd say--- when what he was really thinking was that he'd like to give Wally and The Beaver a swirly or else look up Mrs. Cleaver's dress or something. I was *

I was first tagged with the nickname "Eddie Haskell" in nursing school, where my buddies frequently told me that they wanted to puke whenever they witnessed my well-mannered behavior around any of the nun-instructors or other authority figures of our convent nursing school. * "Th*

"Th*

"That's a lovely nun-habit you're wearing, Sister Kathleen. Why, no ma'am--- of course it wasn't me who started the food-fight in the hospital cafeteria by throwing a cherry tomato at one of the freshmen. I'm SURE it was one of the Seniors..." * An*

An*

Anyway, it was a rough week---and I had to employ my anti-crabbiness coping skills fairly often. I f*

I felt like I was scheduled to see every single patient in Podunk. But to tell you the truth, I really didn't mind seeing the extra volume of patients so much as I hated having to take over Lu-Lu's job of supervising the rookies. Because I'm a sorry supervisor. (Hi*

(Hickese translation: The word "sorry" is a Texan adjective for describing certain negative personality traits or objects. It means "bad" or "terrible".) An*

Anyway, I'm the sorriest excuse for a supervisor that you'll ever see. I'm just not the supervisory type, and it's not because I can't instruct the rookies on the correct ways for doing things---it's mainly because the nutty stuff they do cracks me up too much. I'm just as likely to burst out laughing at their goofy antics as much as sternly instruct them on proper procedure---which really isn't a very effective way to train rookies. Fo*

For example, on Tuesday a rookie named Lori was going out to see one of our new patients and she asked me which topics were listed on that patient's Teaching List. She was supposed to pick one of the assigned topics and instruct the patient on that issue while she was performing her visit. Since the patient has a history of falls and uses a walker to get around, I instructed her to teach the patient about "Home and Kitchen Safety". I w*

I wanted her to teach the patient about eliminating home fall hazards---like throw-rugs and other obstacles which can become entangled in walkers or otherwise trip someone. I also wanted her to inspect the patient's home and suggest better placements for things like loose electrical cords or other clutter which would block the main pathways. I wanted her to instruct the patient about keeping frequently-needed objects on low shelves to eliminate the need for trying to reach while balancing on chairs or dangerous step-ladders--- or else useful tips like making sure to take the cell phone with her when she goes out into the barn in case she should fall while she's out there fiddling around with the donkeys or the goats. There is a plethora of good information that a nurse can teach about safety in the home, kitchen, or barn.... *

La*

Later, I looked at Lori's notes to see how she had documented her teachings. They read as follows: * "Ho*

"Home and Kitchen Safety Teachings as follows:* Instructed the patient to always use pot-holders when taking her pans out of the oven so that things like hot biscuit pans don't burn her.* Instructed the patient to put the cat-food dish under the microwave stand so that she wouldn't trip over the cat while the cat was eating. Instructed the patient....." But*

Bu*

But I never got to the rest of the paragraph because I almost fell out of my chair from laughing about the stupid pot-holders. But then I suddenly stopped laughing when I realized that Lu-Lu would have a conniption fit when she saw those notes---and so I wanted to snatch Lori bald. But*

But that isn't the first time that I've wanted to snatch Lori bald. In her youthful zeal to get things right (bless her heart) she frequently takes the things I've said completely LITERALLY, which has sometimes led to disaster. And so because of that habit of hers, we ended up having to institute a rule whereby she has to show all of her communication faxes to me or Lu-Lu first, before she sends them to a doctor. And that is because of one of the first faxes that she ever sent... Whe*

When she was first hired, I had figured that it was simply sufficient to give her my "How Not to Drive Doctors Crazy by Fax" lecture before allowing her to start communicating with the doctors, where I instructed her to avoid writing long dissertations and to just concentrate on providing information in a "simple, polite, concise and to-the-point" fashion---and to always include a copy of the patient's current medications. I told her that if there's anything that will drive a doctor bat-shit crazy, it's a long-winded fax full of non-pertinent prattling and no concrete information with which to help him make a decision on whatever problem is presented. Lor*

Lori took me very literally on my instructions. Her next fax to a doctor read as follows: "De*

"Dear Doctor So-and-So: Mrs. Dibner reported that she had chest pain today. Her medicine list is attached. Thank you, Lori" Am*

Amazingly, the doctor faxed her back the following sarcastic note:

"Dear Lori: Tell Mrs. Dibner to go to the Emergency Room. Thank you, Doctor So-and-So" Whe*

When I wasn't trying to supervise rookies this week, I was trying to deal with my own patients. Some of them think that I work more in the capacity of the Room Service Attendant at the Ramada Inn rather than as a medical professional. They can be very demanding and even rude sometimes. I truly want to make them all happy but sometimes it's impossible to make everybody happy all of the time. In fact, I think everybody in Podunk must have thought that I was the Room Service Attendant at the Ramada Inn this week.....

An*

And that was when I had to grit my teeth and pray for patience---and that was also when Eddie Haskell started making his appearances....

* P*

Patient says to Me: "I wish you wouldn't come when "All My Children" is on the TV. I watch "All My Children" every day and I don't like to miss any of it. And also don't come between 3:30 and 4:00 pm, either, because that is when I'm cooking fruit cobbler or coffee-cake. We like to have fruit cobbler or coffee-cake after supper and my husband prefers me to make them from scratch rather than buying them." Wh*

What I reply to the Patient, while smiling like Eddie Haskell: "That's a lovely dress you're wearing, Mrs. Schaeffer. Why, of course I'll re-arrange my busy schedule in order not to interrupt "All My Children" or your cobbler/coffee-cake baking schedule." Wh*

What Eddie Haskell was really thinking: Look lady, it ain't like I'm frigging omnipotent like Santa Claus or The Lord---where I can magically appear, simultaneously, in 52 patients' houses at once, according to everybody's TV programs and cobbler-baking schedules. And what in the hell is this about you making fruit cobbler and coffee-cake every day, anyway? Didn't the dang doctor tell you that your damn blood sugar has been through the roof lately? And about your time schedule--- I'll bet that if I drove over to your house right now and snatched you bald you'd find time to see me during "All My Children" or your fruit cobbler/coffee-cake baking time! * * Bus*

*

Busy Hospital Floor Nurse Says to Me: "Your patient is being discharged from the hospital today and you need to go over to his house and change his surgical bandage. But I'm too busy to fax you the wound care instructions right now. I wrote them onto the patient's discharge papers--- so just ask the patient for them when you get to his house." Wh*

What I reply to the Hospital Nurse, while smiling like Eddie Haskell: "That's a lovely scrub uniform you have on today, nurse. Um...many of our elderly patients are forgetful and frequently misplace their hospital discharge papers." Wh(

What Eddie Haskell was really thinking: You're busy? Listen, Florence Nightingale, do I look like a Lady of Leisure who has plenty of free time to sit on my dainty little butt while eating pralines all day? If I screw up and change that surgical dressing incorrectly, that surgeon will have my ASS for dinner! So now, because you won't fax me those damn instructions, I'll have to call the dang Medical Records Department and beg them to do it! And about you "not having the time" to fax that stuff to me--- I'll bet that if I came up to your floor at the hospital and snatched you bald you'd be able to find the time to fax that stuff to me! * * Gru*

*

Grumpy Emergency Room Doctor to Me: "Why in the hell did you send this guy to my Emergency Room? Why can't his OWN dang doctor take care of the guy's abscess by either draining it at his own office or else scheduling another surgeon to do it? * Wh*

What I Replied to the Grumpy Emergency Room Doctor, while smiling like Eddie Haskell: "That's a lovely white lab coat you're wearing, doctor. Um..I really don't have any earthly idea of why the patient's own doctor didn't take care of the problem in just the way that you're suggesting, sir." * Wh*

What Eddie Haskell was really thinking: "Look, doc. The guy's own doctor is as old as Methuselah---in fact, he's so old that his idea of 'anesthesia' is a shot of whiskey and a bullet to bite on. Hell, he hasn't done any of his own surgery since 1978. And furthermore, do I look like I have any kind of authority whatsoever in whatever the Sam Hill you doctors do???? And about you talking ugly to me---I'll bet that if I marched myself over to that Emergency Room right now and snatched you bald you'd talk to me with a little nicer tone in your voice! * * By*

By*

By the end of this week, if I'd been able to snatch as many people bald as I'd fantasized about, there probably wouldn't have been anybody left in Podunk with any hair at all. *

I was running myself ragged trying to keep up with all my patients and the rookie nurses--and I was in such a hurry that I let my photography skills slip a little. I didn't stop to politely ask any of the animals to pose for me---I just snapped their pictures as quickly as I could while driving by in the Jeep. In fact, some of the animals protested that I was taking their pictures on their "bad sides". Who knew animals could be so vain...

Bu*

But I wasn't the only one having troubles this week. Jane-Anne came to work crestfallen on Monday---because she had gotten in trouble with her grandmother.

* "My*

"My husband and I went to church with mee-maw and pee-paw," she stated. (H*

(Hickese translation: In Texas, it is traditional, no matter how old you get, to always refer to your grandparents by the very same childhood nicknames you called them when you were 2 years old--- which is usually "mee-maw" and "pee-paw" for your paternal grandparents, and "ma-moe" and "pa-poe" for your maternal grandparents.) (E*

(Even Governor Rick Perry calls his grandparents "mee-maw" and "pee-paw"....) W*

Where was I? Oh *

Oh yes, I was listening to Jane-Anne tellling me about when she and her husband went to church with her grandparents. "M*

"Mee-maw made us go to church with her to hear their church's Christmas Cantata," she said. "And...well....I couldn't help it, but...well.. um......I accidentally laughed out loud during the Cantata." W*

When Jane-Anne said that, a sudden hush fell over the office. We were aghast. You could have heard a pin drop as all of our eyes widened in horror and disbelief.

"N*

"No..you...did...not!" I said, stricken to the very core of my soul. For*

For those of you not raised in Texas, I will tell you that here in Podunk, the single-most HORRIBLE and HIDEOUS sin that you could EVER commit in your whole entire SORRY life, which would instantly brand you a complete and SINFUL heathen, would be if ... you ever.... ...*

...were to laugh outloud in church. Wh*

*

And it would be even worse if you did it front of your mee-maw. Whe*

When Jane-Anne told us what she had done, all of us in the room stood stock-still in silent mortification and despair, the wind knocked completely out of us at her shameful confession. And poor Jane-Anne just stood there, as sad and mournful as if a big scarlet "H" for Heathen was already tattooed on her forehead. Finally, I mustered the strength to speak. "H*

"How did this happen?" I asked, struggling to comprehend. "Didn't you try the usual things that help prevent laughing outloud in church, like daydreaming about something else, drawing cartoons on the Church Bulletin, or else reading a John Grisham novel behind your Bible? "I *

"I couldn't help it," she stated miserably. "It just popped out." "A *

"*

" Hmmm....a novel behind your Bible...I never thought of that," Lu-Lu wondered in an admiring tone. Jan*

Ja*

Jane-Anne detailed the whole sad saga. "Th*

"The choir was singing "Night of Miracles," she told us. "And ole Miss Cracktower was going to do a solo. But when she started singing, her false teeth started slippin' or something---and so she curled her lips together real hard to keep her teeth in place while she sang. It was the funniest thing I've ever seen, watching her grimacing like that. But that really wasn't the part that made me laugh out loud... " "W*

"*

"*Well then, what DID make you lose control?" Lu-Lu asked impatiently. "W*

"W*

"Well... it was her voice," Jane-Anne stated, grinning at the memory. "Suddenly she hit a high note in her solo and...well...she warbled that note for the longest time! Lord it almost broke the glass in the church windows---it sounded like she was doing the Tarzan Yell. You know how old people do that warbling thing when when they sing?..." By *

By now Lu-Lu and I were laughing hysterically, imagining the scene, and the hapless Jane-Anne plunged onwards in her harrowing tale. An*

And then....my ass-hole husband knew that I was trying not to laugh---and so he started poking me in my ribs, where I'm ticklish--and so I just couldn't help it.... and suddenly a little laugh just popped right up out of me. Mee-maw heard it and I thought she was going to strangle me right there in the church pew." "Yo*

"*

"You idgit!" Lu-Lu exclaimed, wiping laughter-tears from her eyes. "I'll bet that mee-maw wanted to spank your sorry butt." "You *

"Y*

"You can say that again," Jane-Anne replied ruefully. "The first thing she did when we got home was quote the Bible at me, something out of Ecclesiastes about how "the heart of fools is in the house of mirth” ---and then she made me wash AND dry all the dishes after Sunday Dinner. What's worse is that whenever mee-maw wasn't listening, my stupid husband would start doing the Tarzan Yell at me just like Miss Cracktower's singin', and I wanted to slap him silly." But*

B*

But I had to sympathize with Jane-Anne. And that is because I, too, have a history of running afoul of my own mother and grandmother over my own church behaviors. (But I won't go into details here because my own mother reads this blog and I don't even want to get her started...) And *

And then, the week actually ended a heck of a lot better than it had started out. And so I really shouldn't complain at all. To *

To all our great relief, Friday finally arrived, our sick patients seemed to be getting better, and Lu-Lu lived through her own illness. And all of us were excited because not only was Friday payday, but it was also the day that our company's owners were throwing their annual Merry Christmas, Podunk! Christmas Party.

AAnd it was rumored to be the day that the company owners were going to hand out Christmas bonuses with our paychecks. I f*

I followed Jane-Anne over to our owners' house for the Christmas Party. They live on a huge ranch about 20 miles out of town and I was completely awestruck by that place. To get there you have to drive down a special road, passing by two ominous signs that say "No Trespassing" and "This Property Is Digitally Monitored".*

(Lu-Lu told me that there's cameras in the trees watching everything that happens on the ranch, which must mean that there's umpteen cameras to cover all 124 acres.) Th*

The owners did indeed throw a rowdy, Texan shindig. They had invited all of the employees from their various businesses and the Texan hospitality was flowing, along with tons of food and drink. The first thing each guest heard when they arrived was a big "Hidy!" from the whole crowd, and then each person would be ushered around to help themselves to a plate-load of brisket dinner. I even met Jane-Anne's mee-maw, who was helping out in the kitchen, and her pee-paw, who was helping cook the briskets out on the patio. Sin*

Since I don't drink, Jane-Anne begged and pleaded with me to switch with her as the "on-call nurse" for that night, taking her place as the "on-call" so that she could stay up late and whoop it up. I took pity on her and agreed to it, especially since I could see that her unruly husband was already three sheets to the wind from drinking too much whiskey himself. At a*

At about 10:00 pm Jane-Anne's husband sidled up to where we girls were chatting in the dining room and whispered: "Hey, guess what? I think mee-maw's getting drunk! She doesn't realize it but she accidentally picked up Uncle Dean's cranberry juice--- and it's loaded with vodka!" Jan*

Jane-Anne and Lu-Lu looked horrified, knowing that their Bible-thumping, tee-totalling mee-maw had never touched a drop of alcohol in her entire, saintly life. But all I said was: "Now there's two words that I never thought I'd hear used in the same sentence --- 'mee-maw' and 'drunk'." I we*

I went home early that night since I was the "on-call" nurse, but that was okay because I'd had a wonderful time. It was the perfect ending to a horrendous week. On the way home I opened up the envelope that Lu-Lu-'s and Jane-Anne's Uncle Dean had handed me (along with a hug) as I was leaving the party. Inside there was my paycheck... and another check, written on a personal account. The second check was my Christmas bonus.... * It *

It was a check for $500.00, accompanied by a note thanking me for my hard work and wishing me a Merry Christmas. And I started bawling---I was very touched, because I've never gotten a $500.00 bonus from an employer in my entire life. * (A*

(And for the whole rest of the evening I couldn't help wondering if poor mee-maw had really ended up getting drunk....) * *

*

Thursday, December 14, 2006

Thursday....

* ***GOSH and WOW!*** * * ************************************************************** I am totally THRILLED that my last blog posting, "Rough Girls", was mentioned in the "Change of Shift" section of Protect the Airway , a blog which catalogues the experiences of a clinical nurse in a major metropolitan Emergency Department! (It's in the "Art of Nursing" category.) 8 * * * * * *

*I am very honored to be included!! *Thank you!

*

Monday, December 04, 2006

Rough Girls...

I'll shoot it to you straight,
and look you in the eye,
so give me just a minute and I'll tell you why,
I'm a rough boy....
*
("Rough Boy", ZZ Top)
*
*
(If my photography looks different it's because I just got some new software for my photographs and I can't resist playing around with it---but I'm probably playing with the pictures too much because some of them are turning out like psychedelic hallucinations....)
*
Several times in the last year or so I've been asked to train rookie nurses and/or new hires into the Road Nurse field. The first thing the new ones always ask me is: "What does it take to become a good Road Nurse?"
*
And then I always have to bite my tongue before I frighten the rookie to death by saying something ominous like: "Well....uh... it's a rough bunch of girls...." Which sounds very negative and unappealing. But I really don't know what other word to use because it's actually a pretty difficult question to answer. And in my honest opinion, the life of a Road Nurse actually can be pretty "rough" compared to the more controlled environment of a hospital.
*
Even if I were to try and be more concrete or descriptive about which "skills" are needed to be a Road Nurse, I'd have a hard time there, too. Because in my experience, it's not so much that a nurse must develop a particular set of skills to be a Road Nurse as much as it's the complete other way around: that there just seems to be certain types of nurses who gravitate toward this field.
*
But even when I use the word "rough" to describe the average Road Nurse, that doesn't mean that Road Nurses necessarily "look" rough. Some of the Road Nurses I work with are the sweetest, most angelic-looking little snips you'll ever see---daintily sashaying around in crisply ironed uniforms, color-coordinated clogs, perfectly manicured French-Tip fingernails, the latest snazzy highlighted hair-color jobs and hair cuts---bedecked with sparkly earrings and jangly bracelets to boot. Some Road Nurses look like they just walked off the pages of the "Peaches Nurse Uniform" catalog.
*
But don't let those innocent faces fool you...these ain't no Shrinking Violets. Actually, you've definitely got to be a pretty hardy soul to thrive in this business.
*
It takes the kind of person who doesn't mind living most of their life in their vehicle, on a fairly dangerous Road, out in the midst of whatever the weather is doing, where every day's events are changeable or unpredictable--- and where a girl has to juggle a vast amount of precise paperwork with the gritty reality of entering all sorts of private dwellings in all sorts of terrain. Road Nurse Companies are well-known for their budget slashing policies, and they routinely schedule an unrealistic amount of work on their nurses. Most of the Road Nurses I know log in countless hours of unpaid overtime---it's just a fact of the job. Thus, an inescapable facet of this profession is that any nurse entering this field will figure out in a very short period of time whether she loves it or hates it--and then decide for her own self whether or not she "fits" into the profession. (I keep using the term "she" since a male Road Nurse is rare--I've seen a few here and there but they always seem to quit--and I really don't know why.)
*
And I will concede that some of us most definitely do perhaps look a little rough around the edges....
*
Some of us are tattooed, we wear Levi's on our "on-call" weekends (when our bosses aren't looking), and our clothing ensembles contain what resemble Pancho Villa's bandoliers due to our habit of keeping multiple cell phones, beepers and iPods slung along our belts (with iPod ear buds dangling from our ears)---while toting multi-pocketed nurse bags and Hazardous Waste kits over each shoulder. And we might stick our hair up into skewed topknots to keep it out of our way.
*
I will admit here that I have tattoos on both of my arms. I have a ring of barbed wire around the biceps of one arm and I have my former Biker Chick Initials displayed on the other arm. (I used to be married to a biker--but I lost the Harley in the divorce, okay?)
**
Clothing and tattoos aside, I guess if I were really pinned down about having to define the Road Nurse Personality, I would have to go ahead and admit that there is most definitely a very quirky personality that I see in most Road Nurses. (And notice that I'm using the word "quirky" in order to avoid the words "crazy" or "insane"....)
*
For instance, take Belinda. She is one of those small, delicately prissy girls who looks like she'd never blow her nose in public or utter a cussword. She is so sweet and nice that patients' families frequently invite her to lunch or Sunday Dinner. Most of her patients dote on her life so much that they display her child's picture on the same wall that they hang their own children's pictures on--and they all call her on her private cell phone when they have a problem instead of calling the Road Nurse Company. But her slight and ladylike appearance belies her singleminded, dogged determination to get the job done--in whichever way is the most expedient.
*
One of Belinda's weaknesses is that she is too soft-hearted to bring herself to nag any of her patients if they don't do what they are supposed to do--and thus they are all spoiled to death. One time she was having difficulty with a stubborn patient who kept carelessly allowing her leg bandage to get wet in the shower--- which was causing the bandage to subsequently fall off and expose the open, infected wound. After the tenth or eleventh time it happened, a frustrated Belinda called me on the cell phone. "Can you come over here and talk to Eunice-Lynn about this wound dressing?" she asked. "I can't get her to take me seriously about keeping it dry and intact."
*
"What am I--the Gestapo?" I asked. "I'm busy--I'm in the middle of drawing somebody's blood here. Just put your foot down and tell Eunice-Lynn to keep her damn bandage dry."
*
"Just get over here right now--I think she'll listen to you," Belinda persisted impatiently. "You've got tattoos. And besides, she used to be my 6th grade math teacher--- and so she isn't used to one of her students bossing her around. But watch out for her stupid cow when you get here--he's nosy as hell and always sticks his nose out of the fence at me--and he might want to see your tattoos."
*
*
Right off the top of my head I would say that the most noticeable trait I have seen in almost all the Road Nurses I've ever known is irreverence. Road Nurses are the most irreverent people I know. I don't care how sweet and innocent they appear, how quiet, how mannerly, how "Goody-Goody", how church-going, or how professional they look on the surface---dig a little deeper and you'll find a Rebel At Heart who bucks the establishment and loves to clown around. (None of us can ever sit next to each other at church because there is simply no WAY that we can keep a straight face and refrain from giggling like schoolgirls for an entire hour...)
*
Most of us are forever getting into trouble for something or other, mostly for our continual horsing around. We start our days in the office by boisterously gathering our clipboards and paperwork, tossing files and medical supplies around as we chatter like magpies while getting ready for the day on the road--- gossiping about whatever happened to us in the night, and griping about our personal lives--- usually until our boss screams at us in exhasperation to "get the hell out of here and go see the patients, dammit!" And then off we go in our various directions--- to ranch country, to horse country, to chicken farm country, or wherever....
*
Then later, when we return to the roost at the end of the day, the boss will again try in vain to get us to settle down enough to give professional Case Conference reports--a difficult feat, because by then we're all cracking ourselves up telling and re-telling the day's outrageous Road Stories (usually with great embellishment) and laughing so hard that tears are running down our cheeks. Our patients sometimes do the funniest things--and we just can't resist telling each other about their latest foibles. Last week there was a good story--and it was Jane-Anne who told it.
*
"I was at old Mrs. Bindersween's going over her medicines with her," Jane-Anne said. "I asked her what she takes for pain and she said she had a brand new pain medicine that works 'like a charm'. She said she saw it on the TV---and then she whipped out a Ban Roll-On Deodorant from a basket on the kitchen counter. I stared at it like a dummy."
*
"Do what?!" I asked.
*
(Hickese translation: The expression "Do what?!" is a Texan expression which means "Excuse me??", and is usually uttered in a shocked tone to indicate that you simply can't frigging BELIEVE what crazy thing the person just said to you--- and you'd like them to repeat it just in case you didn't hear them correctly the first time.)
*
(Actually, it is a little-known fact that "Do what?!" is actually what the guys at NASA's Mission Control Center replied when the astronauts first radioed them to say: "Houston, we have a problem." )
*
"Yes, she showed me a Ban Roll-On Deodorant," Jane-Anne repeated. "She said that it is what she uses for pain. I said 'Do what?!' again and she explained that she saw a commercial on the TV that said that you're supposed to use roll-ons for headache medicine and so she decided to get one for herself. But I don't think she realizes that the commercial she saw was one of those crazy info-mercials."
*
"Oh my GOD--- she's talking about that stuff called 'Head On' !" Lu-Lu exclaimed. "I saw that TV info-mercial too! But that stuff is a hoax--somebody analyzed it and proved that it's just wax and isn't really a valid medicine at all."
*
"Well...I wonder why in the hell she'd think that just ANY roll-on deodorant was the same thing as what's in that TV commercial?" I asked stupidly.
*
"Well, you're not going to believe this," Jane-Anne said. "But she actually KNOWS that it's not the same thing as in the commercial---she just thinks that it's the 'generic' version! And if you want to know my opinion, what could it possibly harm to let her keep on thinking that? She says it works better than anything her doctor ever gave her. So I stopped trying to convince her that it wasn't a pain medicine and just left well enough alone."
*
And as far as we know, Mrs. Bindersween is perfectly happy using that Ban Roll-On for her headaches. We haven't gone so far as to write it down on her medication list, but we probably ought to...
*
Actually, our end-of-the-day Case Conferences can get pretty raucous sometimes. Patients do and say the nuttiest things, and it all gets discussed at the end of the day. A Road Nurse giving her daily report will usually just prattle along, giving the medical details right along with her patient's comments or her own two-cents worth.
*
Here's a sample of some of the comments you might hear during a daily Case Conference:
*
"I told Mrs. Denfy that her doctor wanted her to switch to sugar-free pancake syrup and she said that if she had to eat that junk she'd urp. And for the rest of the day I couldn't stop wondering what in the hell 'urping is'?--is it like pukin'?... or burpin'?... or what?"
*
"You know how stone deaf Mrs. Janeway is? Well I told her that I had come to change that bandage on her 'private parts' but she couldn't hear me--- and so I kept having to yell it pretty loud--and then finally she suddenly hollered out at me: 'Why don't you just call it a pooty-tang like my momma used to?'"
*
"That's nothing. Old Mrs. Renfro calls a 'sponge bath' a 'whore bath'. Why in the hell do all these little old ladies call a sponge bath a 'whore bath'?"
*
"I was talking to ole Mr. Swenson about his doc's suggestion that he move to a Retirement Community and he said that the only way he'd ever leave his ranch was when they hauled his cold dead body out of the cow barn."
*
"That pervert Mr. Wilson asked me if I knew 'what Burger King and my body had in common'--and I said 'Do what?!' and he answered: 'they both have Whoppers'--and I told him that he shouldn't say stuff that pisses me off like that when I have a needle in my hand, and so he shutted the hell up. From now on I'm not going near that old coot unless his dang wife is standing RIGHT there."
*
"I told Mr. Lindy that his doctor was recommending knee surgery and he said 'Forget it, I ain't paying for his damn Mercedes'!"
*
"I got the home health aide to help me hold up Mrs. Wrigley's legs so that I could catheterize her and during the whole damn thing she kept yelling: 'What in the hell are you DOING down there, drilling for OIL?'---and it drove me plumb nuts."
*
"I was trying to talk Mrs. Benner into going for a female exam but she kept saying that she was too shy to let that doctor see her nekkid---and so I told her 'Oh for heavens sakes, just GO---I've been going to him myself since I was 14 years old, and in fact, he's the first doctor who ever saw my coochie'."
*
"I asked our new patient what his dog's name was and he said: 'He ain't gotta name--but why don't you try calling him something and we'll see if he answers to it?' and so I called him 'Dog!' but the dog didn't look at me, and so the patient said 'Well, it ain't Dog, then.'"
*
"I asked Mrs. Reese if she'd gone to visit her husband at the nursing home and she said: 'Yes, I did--and that old whore dog grabbed my titty right in front of the nurse'."
*
Some of us Road Nurses are are a little sneaky. The neat thing about being a Road Nurse is that you're out of the office at God-knows-where for half the day---and your visits are so varied in their distances from each other, and their time-lengths, that the Road Nurse bosses have no earthly idea how long it really takes you to complete your visits. Thus, Belinda and I are famous for sneaking off in the middle of the day to gossip somewhere. I don't care what we're doing, how many miles away from each other, or how busy we are--we can always find 20 minutes to sneak off to a Dairy Queen or somewhere to catch up on the latest Road Nurse gossip.
*
One day we had planned to meet at 1:30 pm in a nearby hamlet at a barbecue place. We knew that nobody we worked with would be out in that direction to catch us goofing off. But at about 12:45 pm my cell phone started ringing madly, the ringtone that I've assigned to Belinda's calls--and when I punched the button to answer it I heard Belinda yelling: "Abort! Abort! The Paramedic Truck just headed out that direction and Lu-Lu's ex is on it!"
*
Speaking of goofing off, I am the world's worst. I am forever clowning around and have frequently gotten into a lot of hot water for it. One of my worst faults is that I like to make up stupid song lyrics to sing to the tune of regular songs. (I'm like the nurse equivalent of Weird Al Yankovic that way...)
*
In fact, have I ever sung you my version of "The Twelve Days of Christmas"? I call my version "The 12 Days of Narc Counting" . I penned it a few Christmases ago when I was working in Emergency Rooms so as to make the boring chore of counting narcotics at the beginning and end of every ER shift a little more interesting. One night it was quiet in the ER and so I started horsing around by singing this dumb song in my best imitation of the opera singer Maria Callas. I belted out the song not realizing that my evil co-workers had surreptitiously turned on the hospital's PA system during the last stanza---thus enabling the entire hospital to hear the last verse:
*
"On the 12th day day of Christmas my Narc Count said to me...
*
Twelve Ativans!
Eleven Morphine Sulfates!
Ten Point-Five Xanaxes!
Nine Phenergans!
Eight Loose Valiums!
Seven Hydrocodones!
Six Doctors' script pads!
*
FIVE NARCAN VIALS!
*
Four Toradols,
Three Stadols,
Two Darvocets,
*
AND A LOST TUBEX MEPERIDINE!"
*
I've been a Road Nurse in other states before, but things seem a little grittier here in Texas. A Road Nurse here definitely needs to be comfortable with frequently having to leave the main roads in order to four-wheel it through the endless dirt of large cattle ranches and chicken farms in all kinds of weather (and for some reason, we seem to prefer driving the largest SUV's possible---if we could afford Hummers, we'd drive those).
*
*
In this rural area it helps if a Road Nurse is able to do things like stop her daily run to tow a disabled vehicle out of a muddy ditch, be comfortable working among a lot of animals (both IN and OUT of the household), tolerate driving very long distances in a single day---and I will add here that most of us also pride ourselves on being able to shoot a gun as accurately or better than any man around.
*
*
Also, an increasingly large number of our patients do not speak English---being from Mexico, they speak Spanish. Having spent a large part of my younger life overseas, I speak fairly good Spanish, which has always come in handy for my nursing jobs here in Texas. But I learned my Spanish in the various countries of South America---and the slang terms there mean different meanings than those used in Mexico's particular Spanish dialect. And I found that out the hard way one time.
*
I was working in an ER and was trying to tell a Mexican couple that I needed to take their baby's temperature rectally, in his 'bottom'. I'd used this phrase a thousand times in that ER without a problem, and so I felt somewhat disconcerted when the father appeared flustered and instructed me in Spanish "that a better word for 'bottom' would be such-and-such word." I complied with the word he desired and didn't think another thought about it. Until later when I mentioned it to one of the ER techs, a Mexican guy. He turned white as a sheet and asked: "You used WHAT word for 'bottom'?" When I told him the word that I'd been using for 'bottom' he doubled over in laughter, explaining between guffaws that the word I'd been using might be perfectly acceptable in South American Spanish---but that in Mexican Spanish it was a street-slang term for 'asshole'...
*
And after I got over my embarassment about THAT, I got embarassed all over again---because I realized that I had been using that word in the ER for a solid year, mostly whenever I asked Mexican adult patients to bend over so that I could give them a shot in their "bottom"... ("Please bend over so I can give you a shot in your asshole!" I'd said cheerily, brandishing my needle. NO WONDER those people had all looked frightened as rabbits ....)
*
But whether from Texas or any other state, most of the Road Nurses I know are inherently independent (aka stubborn) , completely fearless (aka calculating risk-takers) , and hopelessly optimistic (aka "can I get away with this?") . Inevitably, with this combo of traits, many Road Nurses seem to have very contradictory personalities.
*
For example, Lu-Lu's young cousin, Jane-Anne, is a canny and skillfull Road Nurse. I've seen her gun her vehicle mercilessly to see 9 patients in a single day, fill out reams of complicated paperwork on the side of the road while slurping Campbell's Chicken-Noodle Soup out of the can, one-handedly obtain a blood sample in one stick from sick patients with no visible veins while yelling "One Dollar!" with her patient while watching the TV show "The Price is Right" , squat down on a filthy, roach-infested floor to help fix a patient's broken oxygen tank tubing, help an elderly patient stir a boiling pot of chicken & dumplings, change a bloody wound dressing in 6 minutes flat while discussing a hushpuppy recipe with her patient's wife, bring bags of dog treats to toss at her patients' yard dogs--- and then report every single pertinent detail of a patient's condition with precision accuracy to a doctor over her cell phone while driving back to the office.
*
And yet.... Jane-Anne is the quintessential innocent, corn-fed country girl---pure as the driven snow, wearing her blonde hair in school-girl pigtails, married her high school sweetheart right out of high school, and flushes bright red whenever anybody cusses within her earshot. It is not uncommon for Jane-Anne to approach a more experienced nurse to shyly ask for advice on how to handle her monthly menstrual cramps or her unruly husband---or to solemnly inform one of us that she has commited some minor "sin" for which she has to ask The Lord for forgiveness.
*
(The last time she did this was because she felt guilty for slamming a box of Hostess Honey Buns down on her kitchen floor in anger at her husband--and she was extremely relieved when I informed her that it is every woman's God-Given Right to throw Hostess Honey Buns or any other dang thing down on her own kitchen floor because of her dang husband if his behavior so warrants.)
*
(Okay, it might not be said that exact way, word-for-word, in the Bible but I'm pretty sure that it's paraphrased in there somewhere.)
*
Actually, Jane-Anne's innocence of worldly matters is astounding sometimes. The other day we were hosting a Blood Pressure Screening at the grocery store and during a lull I went around the circle asking everybody: "How old were you when you found out that there isn't really a Santa Claus?"
*
When it was Jane-Anne's turn to tell she related that she had not found out that there was no Santa Claus until she was 12 years old.
*
When I heard this little tidbit I couldn't help bursting into laughter so suddenly that I dropped my stethoscope right on the floor by the Ben Gay display. I sat down next to one of my patients and laughed so hysterically that I almost peed my pants. Jane-Anne looked stricken and so Lu-Lu piped up sypathetically and said "Oh hush up, Bohemian! Our family wanted to shield her from the truth for as long as we possibly could!"
*
But I couldn't help myself. "Shield her from the truth?" I laughed, hiccuping. "Till she was TWELVE? For Christ's sakes, Lu-Lu, were you guys just going to let her believe in Santa Claus till she was married? Think about it---all the other girls were putting on lipstick and kissing boys under the mistletoe at Christmas---but poor little bird-brain Jane-Anne was hanging her dang stocking up like an idiot and putting out milk & cookies for Santa Claus!"
*
"And deer corn for his reindeer," Jane-Anne added.
*
After I calmed down, Jane-Anne proceeded to tell me the whole tragic story.
*
"It happened one afternoon when my brother and I were in the back horse pasture," she said solemnly. "And he accidentally blurted out that while he was in the barn he had found some hidden boxes that were full of Christmas presents. I said 'Do what?!' and ran to look for myself--and sure enough, there they were! I ran into the kitchen to ask my momma about it and she tried to tell me that Santy Claus had simply put the presents there for safekeeping until Christmas."
*
*
"That's a reasonable explanation," I stated. "So then what made you stop believing in Santa Claus?"
*
"Well hell, I ain't no fool!" she replied indignantly. "I knew damn well that Santy Claus wouldn't bring your dang presents in boxes with the dang price tags still on them! I bawled for a week and my mother smacked my brother upside his stupid head for ruinin' Christmas for me!"
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Then she thought for a minute and added: "And please don't tell my momma that I just said the word 'hell', okay?"
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Speaking of contradictory Road Nurses, Lu-Lu is the most contradictory nurse I've ever met. On the outside, Lu-Lu looks like your typical Texan-Belle, similar to the proverbial Southern-Belle, but with a Texan accent. She is beautiful to the point that she is often teased about being a Paris Hilton look-a-like. She is sedate, ultra feminine, unfailingly polite in all situations, never rude, and always respectful to her elders. Patients love her and think she is the epitome of an earthly angel.
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And two months ago she was in a bar fight.
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"I had to defend my honor, dammit," she told us the next day when she showed up at the office looking slightly bruised and ruffled.
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"What in the hell happened to you?" I asked.
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"You remember how I stole my boyfriend, Luke-Henry, from that hussy girl from West Podunk?" she said guiltily. "Well, last night she got drunk and came up to me in the bar and called me a 'low-down-man-stealin'-fake-blonde-idiot'---and so I had to knock her down."
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"You knocked her down?" Jane-Anne asked incredulously. "I thought you gave up fightin' when you graduated from high school. Uncle Dean would kill you if he knew about this." (Lu-Lu and Jane-Anne's Uncle Dean is the owner of our company....)
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"I don't give a rat's ass," Lu-Lu retorted. "Because it's one thing to call me a low-down-man-stealing-idiot. But I ain't gonna let NO HUSSY get away with calling me a 'fake blonde' in front of all the boys! That just ain't right! But then after I knocked that damn hussy down she came up fightin' like a crazy woman---and all the boys started yellin' 'cat fight! and taking bets on who'd win!'"
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"Who did win?" Jane-Anne asked.
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"I did, of course," Lu-Lu said defiantly. "I fixed her little red wagon but GOOD. But now I cain't go back to that damn bar anymore."
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This is also a job where a Road Nurse needs to be completely flexible--because the job involves more than just visiting a "set" list of patients. Some days unexpected issues arise and your boss changes your schedule around so fast that you're literally making U-turns in the middle of the road after she calls you on the cell phone. You learn to keep plenty of medical supplies and a master patient address list in your vehicle for those unexpected lab tests, fall assessments, urine samples, medicine-box set-ups, neuro checks, blood glucose checks, or cuts and bruises.
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Also, there are times when you're not so much helping a patient live as much as you are helping them---and their families--- deal with death. At least three times this year we have gone to the funeral of one of our patients. The last one we attended was a grave-side service where we stood sadly alongside the open grave with the patient's family, in the boiling hot Texas sun, while a minister preached a funeral sermon.
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One thing about the preachers around here is that they never forget to read one of my favorite Bible quotes during funerals, that Biblical promise of what it's going to be like in Heaven: "...and God shall wipe away all tears from their eyes. There shall be no more death, neither sorrow nor crying, neither shall there be any more pain...."
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One of the bad things about this job are the inevitable societal hazards. Since a Road Nurse must work within and among all of humanity's behaviors, good and bad, (and although most of our patients are beautiful, loving, and kind people) it is unavoidable that a Road Nurse must sometimes encounter extremely unpleasant situations. The following are some of the situations a Road Nurse, whether in Texas or any other state, may encounter during her work day:
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- Street gang/drug activity in or around the household she is visiting;
- Domestic violence in the household;
- Hopeless poverty and filth;
- Alcohol or drug-abuse by patients and/or their family members;
- Violent or abusive patients;
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And this job is not exactly the highest-paying nursing job in the country. A full-time Road Nurse must usually work 5 full days a week plus her turn for those dreaded nights & weekends as the "on-call nurse", where she provides an after-hours resource for unexpected events, extra bandage-changes, or blood draws. These hours are frequently much worse than those of other nursing jobs. For example, when I used to work as an ER or ICU nurse, I only had to work three 12-hour shifts a week to qualify as a full-time employee with benefits---and I never had to be "on-call".

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But I guess what attracts me and a lot of other girls to this profession the most is the freedom. For some reason, there's something exhilerating about hopping into your vehicle on sunny Texan mornings--heading out towards ranch country with a big car-cup full of good, rich coffee---not knowing what adventures to expect for that day.....and getting to see a flock of ducks lift off of a beautiful lake.... watching the turtles sunning themselves on the banks of the creeks.... waving at the farmers driving their pick-up trucks.... catching a bite to eat at the Dairy Queen with Belinda.... chatting with charming little patients while watching a game show on the television set.... talking with your patients' animals and getting their point of view.... changing a bandage while swapping recipes with a patient.... laughing with your buddies at the end of the day....

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Hell, I guess it ain't so rough....

(In fact, I'm thinking of getting a new tattoo of a Jeep on my ankle.... )

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