Nurses' Duties in 1887
 

  "The item below is from a newspaper clipping Lis Turley RN found in her mother's old Bible. The clipping outlines the job description given to floor nurses by hospitals in 1887.

In addition to caring for your 50 patients, each nurse will follow these regulations:
(nowdays, we're lucky to have only 5-6 patients per nurse)

1.  Daily sweep & mop the floors of your ward, dust the patient's furniture & window   
     sills.  (Be grateful for the Housekeeping staff that does this for you!)

2.  Maintain an even temperature in your ward by bringing in a scuttle of coal for the
     day's business.  (Wonderful A/C & heating units! Lovely maintenance guys that
     keep those things working!)

3.  Light is important to observe the patient's condition. Therefore, each day fill
     kerosene lamps, clean chimneys & trim wicks. Wash the windows once a week.
     (I wonder how many fires they started?  Thank goodness for electricity!)

4.  The nurse's notes are important in adiing the physician's work. Make your pens 
     carefully; you may whittle nibs to your individual taste.  (The nurses' notes are still
     an integral part of our jobs but very few MDs read them. Although we don't have to
     make our pens, we've just been told that the hospital will no longer buy them for us;
     we're now expected to bring our own, as they are part of our personal equipment,
     like stethescopes. How cheap is that? How many people know what a nib is?)

5.  Each nurse on day duty will report every day at 7am and leave at 8pm, except on
     the Sabbath, on which day you will be off from 12noon to 2pm.  (Are you kidding
     me? Do you have any idea how unsafe that is?  I work three 13hr shifts in a row
     & am mush come the third.  Seven in a row? No time off except for church?  Labor
     laws sure have changed.)

6.  Graduate nurses in good standing with the director of nurses will be given an
     evening off each week for courting purposes or 2 evenings a week if you go
     regularly to church.  (I guess the majority were single women because a married
     woman had her husband to support her?  Can you imagine your boss giving you a
     day off so you could go on a date?)

7.  Each nurse should lay aside from each pay day a goodly sum of her earnings for
     her benefits during her declining years so that she will not become a burden.  For
     example, if you earn $30/month, you should set aside $15.  (Well, obviously since
     these ladies aren't married they don't know what to do with their money & need
     someone to tell them to save for retirement; after all, an unwed woman is just a
     spinster who lives off the charity of her male relations.  Oh and nurses make more
     than that in one hour nowadays, depending on where she works & her level of
     experience.)

8.  Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty
     shop or frequents dance halls will give the director of nurses good reason to
     suspect her worth, intentions & integrity.  (Well, hell.  I guess every one of us is
     suspect now!  I find it ironic that the majority of Respiratory Therapists -who give
     breathing treatments-smoke.  Shouldn't they know better?)

9.  The nurse who performs her labors & serves her patients & doctors without fault
     for five years will be given an increase of five cents a day, providing there are no
     hospital debts outstanding.  (Five cents a day? Hospitals have to keep up with the
     costs of living & with the competition if they want to keep their staff. 
     Unfortunately, my hospital is still behind the others in my area but, oh well; I still
     get my yearly raise. And nurses are expected to be advocates for their patients
     instead of blindly following the doctor's orders.)"

So the next time you see a nurse, give her (or him) a thank you.  Nursing is a hard job, often thankless & frustrating, but usually rewarding.

Also remember to appreciate the support staff you have, from Housekeepers to maintenance to CNA/LNAs (nurse's aides).

And be glad you don't have to clean out chimneys & make your own pens!

Some of them are mine but many are not, especially the icons!

3/2/09 New Story

  Everyone knows that doctors have horrible handwriting.  The ones with the neat, legible penmanship are the exception, not the rule and I'm often called upon to translate the scribble.

   One particular doctor has relatively neat writing but it's very flowing and loopy for a man.  You know what I mean.  He wrote an order for a patient allowing her to have hard candy even though she couldn't eat solids yet.  No big deal.  That's common.

  It was the way he wrote it in his loopy handwriting that set off gales of laughter.  He wrote, "May suck on hard candy."

  However, the "s" looked like a different letter entirely, turning an innocent word into something much naughtier.  Yes. That word.

   The pharmacist called, laughing so hard she could barely talk.  She understood what he really meant but everyone in pharmacy wanted to know, "How are you gonna teach the patient to do that?"

~~~~~~~~~~

2/17/09 New Story

   Our call bell system is kinda fancy (keep in mind the hospital is slow; new age technology filters down to us very slowly.) Has a computer monitor that displays the patient's room when he calls, has lights to indicate the presence of a staff member & comes with trackers so the staff (provided they're wearing one) can be seen on the monitor.  It's not perfect but it's handy.

    Last week, one particular room kept calling. We'd take turns answering the call but each time the patient denied pressing the button or needing help.  We'd hang up and the thing would go off again.  Drove us nuts; the sound it makes is quite annoying.  I did what I could to fix it; reset the system, sent someone to check the connection in the room to make sure it was plugged in properly, replaced the handset. Nothing worked.

   Finally, we called maintenance.  The biomed dude came with all his gadgets and tools and headed for the room.  He spent about 20minutes in there, going back and forth between the main computer and the room, doing many of the same things I'd already tried, but with no greater success.

   After about 20 minutes, he came to the nurse's station with a sheepish expression.  "This thing's about ready to drive me nuts. Good thing I found the problem."

    Turns out that the patient had hung his urinal on the side rail & the handle kept bumping the call button on the rail.

   Good thing we called maintenance to fix that!

   ~~~~~~~~~~~~~~~~~~~~

  I work at a small hospital, small but nice. Or it used to be until it got flooded by the hurricane. They're working on that. Almost done with the reconstruction. I didn't lose my job like the folks down at UTMB Galveston. Luckily.  We're back in our own unit after spending 3 months sharing space in the maternity ward.  Gadzooks! That was awful!
  We'v had a very busy month-been full every day and playing the revolving door game with patients.  We've also had some very strange things happen and also some ridiculous thing happen.  It struck me a few days ago that working where I do, things have the potential to be ridiculous or life-threatening and the day goes so much easier when it's somewhere between the two.
   So, I decided to make little notes about the stupid stuff that happens at work, like my own version of the Reader's Digest column.  If you're not in healthcare you may not get some of the humor but I'll try to explain if it. Keep in mind I can't give real names, either.  Some of it happens between co-workers (and I've got a main source for that!) but some of it comes from patients or their families.
  The first entry belongs to my husband, however, simply because it was too funny.
   Chuckles is the general manager for a Subway restaurant. Behind it, is a nursing home.  Sometimes, he tells me, they let the more lucid and trustworthy residents out for walks and they come to the store for lunch.   Today, he had one such a customer but the poor dear was obviously more confused than any of the others that had been there.  It kinda through him for a loop.
    He overheard another employee speaking to a customer and realized the employee was confused about what the lady wanted.  He poked his head out and saw a little old lady at the counter.  She wanted to buy tuna but without the bread.  No big deal.  He got that straightened out with the employee on how that works and was asked what should she put it in?  A soup bowl, he says.
  "Oh no, dear," the customer says.  "Don't ruin your dishes. Just put it right here."  And she holds out her hands.  "Put it right here, dear.  Do you have a lid I can put on this?"
   Keep in mind they're not used to senile people and the employee wasn't quite sure what to make of that request.  Well, the lady gets her tuna in a bowl, cuz it's no trouble to give her a bowl,and she pays.
   "How much?"
   "Fifty cents, ma'am."
   "How much for 2 scoops?"
   "Well, that would be a dollar."
   "A dollar?  Why, that's twice as much!"
   What's he supposed to say to that?  "Yes."
    So she pays and sits down in the dining room and proceeds to eat the tuna from the bowl.  With her fingers.  Gets it everywhere.
  Chuckles goes out to ask an embarrassed mother if her 3 giggling kids could stop laughing at the poor lady who has tuna dripping down her chin. In clumps.  She's probably embarrassed about it.  Poor thing probably doesn't even realize she's doing it.  Even the construction workers on their lunch break are trying not to laugh at her.
   So the lady finishes up and starts to leave.  With the tuna still all over her face.  Chuck asks her if she's got someone to take her home.  "Oh, they're in the car, dear."  (I want to know why they didn't come in with her.)
    He said it was the weirdest thing he's ever had to do (and remember we've got 3 kids ourselves) but the woman just didn't understand that she had made a mess of herself.  I guess he tried giving her a napkin or maybe tried telling her to wipe her face off but she didn't get it.
   So he wiped her face of for her and sent her on her way.
   The whole rest of the day, the running joke was to request some food item and hold out the hands for it.  "Just put it right here."

   My grandfather had Alzheimer's.  He used to wander down the street buck naked.    We get nursing home patients quite a lot in my unit-usually cuz they've fallen & broken a hip. Sometimes, they're pleasantly confused like the Subway lady but sometimes they climb over bedrails, pull out IV lines and catheters and cuss and scream and hit.  Those are the days when you can hear those guys with the straight jackets calling your name.
    You either laugh a little at the inanity of it all or you go crazy right along with them.
   If I ever go senile like that, somebody shoot me.
  
 
      

Desirada

"Go placidly amid the noise and the haste,and remember what peace there may be in silence.

As far as possible, without surrender, be on good terms with all persons.

Speak your truth quietly and clearly; and listen to others, even the dull and ignorant.                     They too have their story.

Avoid loud and aggressive persons; they are vexatious to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans. Keep interested in your own career, however humble. It is a real possession in the changing fortunes of time.

Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is. Many persons strive for high ideals and everywhere life is full of heroism.

Be yourself.  Especially do not feign affection.

Neither be cynical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.

Take kindly the council of the years.       Gracefully surrendering the things of youth. 

Nurture strength of spirit to shield you in sudden misfortune.

But do not distress yourself with dark imaginings.

Many fears are born of fatigue and loneliness.

Beyond a healthy discipline, Be gentle with yourself.

You are a child of the universe no less than the trees and the stars; you have a right to be here, and whether or not it is clear to you,

no doubt the universe is unfolding as it should.

Therefore, be at peace with God, Whatever you conceive Him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul.

With all its sham, drudgery, and broken dreams, it is still a beautiful world.

Be cheerful.

Strive to be happy."

Author Unknown although some maintain that this piece was written by Max Erhmann 

Patty sent this link to me, from another friend's blog. I just watched the movie and enjoyed it so much! It's sweet and funny with a great big happy ending. I like that! A lot!

http://www.msplinks.com/MDFodHRwOi8vYmxvZy5teXNwYWNlLmNvbS9pbmRleC5jZm0/ZnVzZWFjdGlvbj1ibG9nLnZpZXcmZnJpZW5kSUQ9MTI4ODE2MDYwJmJsb2dJRD00NDUzMjE1Mjg=

So we had our first hurricane of the season, the first in 25yrs actually. Hurricane Ike. Most of you have heard of it; they're still trying to clean up Galveston. Visit my Photobucket account if you'd like to see some interesting pictures.

http://photobucket.com/Renate82_HurricaneIke

But here it is, a month later, and I bring it up again. I wanted to blog about how things are going at wor-during the storm and after and I just never sat down to do it earlier. That's me, for ya.

Anyhoo...staff at work are divided into groups -E1's and E2's- to ensure that there is staff for the hospital during times of crisis. During Rita 3 yrs ago (which didn't even touch us!), too many people left with the evacuation, leaving few staff available.  An E1 is supposed to be available during an emergency and for the duration of it, whether that means traveling with patients or staying at the hospital (or both in this case). They're supposed to go home, get prepared for a stay of any duration, then return. The E2's are the support crew. They come in, ideally, so the E1's can go home, prepare and return. E2's also are the ones that reopen the hospital and prepare to receive patients that have been shipped out.

No one wants to be an E1. Who wants to leave your family and ride a bus full of sick people to a hospital in BFE? There are those who handle it admirably. Fortunately, I'm an E2 this year, no matter how many hurricanes or disasters we have. Next year it flips.

 So Dread Robert asked me did I pack a bag? No. Why not? (and he sounded a little peeved). Cuz I'm not going anywhere. Oh, thanks for the support, sez he. I'm an E2, sez I. I'll be here when you get back, Robert. 

Didn't quite work out that way but whatever...So we know about this hurricane in the Gulf and we're pretty sure it's coming our way.  What do we do? Get our knees replaced! Seriously.  I went into work that Wednesday (storm hit Saturday AM) to find the OR up and running with elective surgeries.  WTF? Did that make any sense?

If you knew a hurricane was coming, would probably power outages and flooding, would you go get your tummy tucked or your knee replaced?  OK: for those of you who don't realize it-a hurricane counts as a natural disaster, natch, and hospitals in low-lying areas (which mine is!) will evacuate any patients they cannot send home. And they're evacuated to whatever hospital can take them. Ours went three different hospitals-in downtown Houston, Katy and Bryan College Station. Guess what? They can't send home someone who's just had a joint replacement or other major surgery! Think about it! Great big storm, probably gonna knock trees over, rip up your roof and fence, break a few windows, flatten your house, but go ahead, have a surgery that will require minimal activity afterwards. Who needs that stress on top of everything else? That our OR was open for those electives puzzles me; that people actually went ahead with their procedures made it worse.

So on Thursday, we had about 20 patients we had to send to other hospitals. The others could go home. Half of our people went with them, the E2s went home. Boy, was I glad of that!

So the hurricane hit Saturday morning and flooded the entire first floor of the hospital.  It sits right on Nassau Bay, only 16feet above sea level. The Sea Wall in Galveston is that high. And the old roof is flat and couldn't take the weight of the water sitting there-whammo! Third and Fourth Floors soaked, Second floor mildly drenched.  The new area of the hospital (mine, thank you) survived intact, except for the aforementioned flooding.

We were supposed to keep in touch so we'd know when to report in, where to relieve the E1's etc. I was bad, I admit it. I didn't go anywhere. The hospital remained closed for about 3wks to assess damage and affect repairs. So I had a two week break. (For our house-power out on Friday night, back on Monday night. Cable/internet out for a week! Never lost water.)

So you figure a couple of days for the nurses that went with the patients. Day of the storm and the next day or two. Right? That's reasonable. Wrong. For some reason, these hospitals didn't have their own staff available which I don't get. Shouldn't they be staffed for their entire capacity? What if every bed was occupied?  Then there were no hotel rooms available for our people; they ended up sleeping 4-5 in an empty hospital room on cots. They weren't fed either (or they ate but nothing was provided.) A couple of days later, my manager Kim said she was able to get a hotel but had to go buy new clothes cuz she hadn't brought enough. She stayed in Bryan for about a week, maybe 2; she promised the other girls she wouldn't leave anyone alone there. Good on ya, mate!

With our hospital closed, some of our staff stayed at those hospitals for the work. Some actually quit to work there. Oh, well. Some had such damage to their own houses that they didn't return to work immediately.

So I went back to work and found our surgical unit relocated to the L&D department, sharing an 18bed unit with the OB staff. Not fun. They opened our little unit on Monday and started throwing patients up there without giving the nurses time to prepare or supply anything.  I got there on Thursday-still only one computer (in a world where just about everything is computerized) only one phone (where the phone rings constantly) and no supplies for male patients. It's an OB unit, for cryin' out loud! It took two weeks to get another computer, another phone but we're still waiting on a printer. It took a week to realize we needed our own Pyxis for the medications, our own supply shelves and some chart racks, extra chairs, extra tables...We have to be really careful about what kind of patients we accept, too, because of the newborns. Surgical is already a clean unit but we must be really picky now- no "-itis" of any kind, if I had my way. Oh, and we're doubling up rooms where there's only one oxygen hook up cuz the room isn't designed as a double! Oopsie! Maybe we shouldn't double up those rooms, the supes finally said. Gee, really? Privacy laws are shot to hell, too, but under the circumstances...Not ideal but we do what we must.  It's not awful, just strange and discombobulating.

We're still in the back of this unit, crammed into a tiny space, doubling up on rooms and struggling to get what we need still. My surgical unit is the ugly stepchild. Poor us. Always thought of last. Our staff always pulled to the medical unit even if it leaves us short.

They are making every effort to give the staff their hours, which deserves applause. Still, I'd rather be cancelled then take care of 2 or 3 patients. Normal load is 5-6. I get too bored with a light load and tend to forget things more readily then when I'm busy. Plus, light load means more time to sit which means more time to get sleepy. Especially after lunch.

Repairs are ongoing. two-thirds of the hospital is out of commision still. Every department is displaced, as in the kitchen is in the radiology department. We've gone from 2 OR rooms to 4 now. Woohoo! That really limited our incoming peeps. The surgeons actually had to use the new Day Surgery Center built last year! Howsabout that! Maybe they'll keep using it. We were told we'd be back "home" sometime in December, which in this case means January. Just today I heard they admitted they weren't going to be ready for December as they had planned. Ya think? I said from Day 1 that it'd be January; nothing ever runs as scheduled in a hospital, especially where construction is concerned.

On a sad note, my mentor and friend Sara is retiring. She's talked about it before, especially since Dread Robert took over, then she moved further away and doesn't really want to drive. She was off all of October until this week since she had the PTO time to take. She came in, asked for Novemeber off, too, as well as Thanksgiving and Robert told her he couldn't promise her that. WTF? She's been there for 27yrs! What the hell is wrong with that man? He's so wrapped up in being in control he can't show appreciation for a nurse that grew up with that hospital?  Shit, she was even there for the last hurricane that blew the roof off 25yrs ago! (She remembers the nurses standing in the halls with umbrellas as they escorted the patients to the ambulances in knee-deep water). She said, well, I guess I need to resign then. Fine, he said. So she did. Sara was a little mad at first, she said, but said today at her party that maybe this was God's way of telling her to expand her horizons, something she'd been considering but hadn't done.

I tried to give this man the benefit of the doubt but it seems more and more that he wants to shove out everyone that isn't his lackey, whether they have experience or seniority or whatever, and hire his own minions.We've had so many old-timers (and I mean that in a good way) leave since he took over as Unit Director. Even our new CNE doesn't seem to care and the CEO has drifted away, too. Super Nurse Peggy used to be good friends with the CEO but now says he doesn't even care what happens to the staff any more. What the hell happened to the leadership there? Our mission is to support the healing ministries of Christ, it says so everywhere you look. Shouldn't that apply towards our own staff?

Most of us are very upset with how Robert has been handling the staff, he may even be running off one of his new Nurse Managers (medical side not mine). I hope Kim is able to speak up for us. We surgical peeps have always stood up for each other and backed each other up; we covered each other for holidays and vacations because we knew it would be return. Robert doesn't get that and he probably never will.

I don't know if I should be really mad about all of this or what. Part of me is upset more about Sara; the rest of me couldn't care less about Robert. Which is why I'm glad I didn't get the Clincial Nurse Manager job. He doesn't intimidate me or affect me in my doing my job. Now, I'll take over Sara's position on Wednesday, too, and charge all 3 days I'm there. I'm it. The boss on the floor. There's only one other day shift nurse with more experience there than me. night shift is a different story.

While Sara was on storm vacation, a 2yr old nurse started charging; she seems to do OK but I hear some don't like her. Ah, well. Can't make everyone happy. Wednesdays I usually work the floor but the second time they put me there with the newbie in charge, I got a little irriated and (nicely!) asked Kim the manager to just leave me off Wednesday if she didn't need me to charge; told her I was rather insulted that the newbie would be given the desk ahead of me. So she fixed it. Thank you. So now that Sara's leaving, I'll take the desk 3 days and the newbie will have it two; gonna train a few others to back us up; plus Kim charges a day or two here and there.

I'm going to follow in Peggy's footsteps and refuse to let that idiot run me off. I've got a family to support and I don't have the energy to go hunting for another job.  I'm not the type to just blow up at people (except at home where they will still love me!) and I don't get riled at work. Takes a lot to get me freaked out. I've always been that way and it's a good quality for a charge nurse to have-that calmness, several people have told me so. I wonder what it will take before I am finally propelled to protest more loudly than I have been, where the higher-ups will hear.

I don't think I'm scared to speak out. I think I might be running towards apathy. That could get dangerous, I suppose.

Don't get me wrong. I care about my job and I'm a good nurse. I don't know everything & I don't claim to. But I leave my job there; I don't take it home with me. I don't worry about it when I'm not there. I don't hang out (much) with my coworkers (except for the odd bachelorette party and that was odd). I don't hand out an a regular basis with a bunch of friends; I'm a homebody really.

Sometimes I wish I felt more passion for my job and I wonder what I'm waiting for. Sometimes I think I'm in the wrong field and wish I could just write for a living. I don't wanna be a stay-at-home mom. I did that for a few months after the first kid; boring! Plus I like getting away from the family for a bit and I do like being a surgical nurse. It's my niche. If I could be anything else, I'd be a writer.

I guess obsessive fangirling isn't a valid career option.  No dental or medical. No income. Shit.  Too bad the folks at Supernatural don't need a nurse on hand. You know, to bandage and apply ice or otherwise consult. *sigh*

Maybe this is a little depressing and I haven't really acknowledged it. I've been bitchy the past few days but that may be hormones and the girls still drive me crazy. I find I have a better sense of humor now and am making Chuckles laugh more. That's good, isn't it?