Journal of Nursing Jocularity

photo by Benjamin Earwicker

A recent revelation in my own life brought back memories of a patient I cared for many years ago. The expectant mother, who was married, well educated, and in her thirties, attended all six prenatal classes with a smile on her face. Following the final class she pulled me aside and spoke of how frightened she was about the pain she would feel during childbirth. The youngest of five siblings, she had always been called the “cry baby” of her family. Apparently the running joke throughout her pregnancy was the family’s concern about her ability to tolerate a labor contraction, given the terror she displayed over removing a simple splinter during her childhood.

Her uncomfortable laughter was no disguise for the self doubt she was revealing. Ultimately, she decided to speak in greater depth with professional counselor and kept in touch.

I hadn’t thought of “Cry Baby” in years until Cheryl and Colleen, two of my best girlfriends from back in junior high school, visited a few weeks ago. We were enjoying breakfast on the sun porch when something was said about my eyes. Suddenly I was transported back in time. (more…)

Nurses love charts, right?  After all, you spend so much time with them!  Here at JNJ, we thought that since charts are so popular, we’d add one more: Star Charts — horoscopes, designed specifically for nurses!

Aries         

Remember Mrs. Grouchalot, who knew you couldn’t do anything right?  Remember how glad you were to see her go home?  This week brings her — and any other lingering, unresolved problems! — right back to your floor.  Avoid both unrealistically high hopes — Mrs. G didn’t have a personality transplant while she was away — and deep despair.  New influences appear on the 24th which may shed entirely new light on the situation.

Taurus

Not normally a social butterfly, shy Taurus comes out of her shell this week.  Don’t be surprised to find yourself caught up in the chatter at the nurses station or making fun plans for the end of the shift — just don’t let the charting slip off your radar!  Keep an eye on spending, particularly during the 24th.  Skip the vending machine and save your money!

Gemini

There’s no I in TEAM, Gemini!  The stars might be shining, but that doesn’t mean it’s your turn to step into the spotlight.  Focus on teamwork and cooperation instead: share the glory (and workload!) while sidestepping any blame — particularly on the 27th.  Let someone else volunteer to head the JCAHO committee. You’ll be glad you did!

Cancer

The beginning of the week is going to be particularly rough — for you and those around you.  (Might not want to tell your patients that!)  Be proactive and fight off the bad mood.  You influence more people than you know.  One smile can transform multiple days!  Surprising influences crop up on the 28th, perhaps from a visitor or patient’s family member.

Leo

You’ve got it going on!  Nothing is going to phase the Leo nurse this week.  Projectile vomiting?  No big deal  Three codes in thirty seconds?  You can handle it — you’re SuperNurse! 

Roll with the punches — but keep an eye on the money situation.  Check your paystubs, bank balances and bills carefully — or you’ll finally find something that makes YOU turn green.

Virgo

It’s hard knowing everything, isn’t it?  Your attention to procedure and protocol is admirable, but be too anal-retentive at your own risk.  The nurses you work with are human too — and you’ll want and need their human understanding on the 28th.  Don’t lock yourself in the isolation ward of perfectionism!

There’s love in the air for Virgo on the 24th — be ready!

Libra

Thinking of abandoning the hustle and bustle of the ER for the relative calm of psychiatric nursing?  Looking for greener pastures in geriatrics?  This is a positive time for change, Libra — if you want to make a move in your personal or professional life, the 24th is a great time to start!

Scorpio

Better have those batteries charged, Scorpio!  This week is going to take a lot out of you.  From high maintenance patients who hit the call button every 2.2 seconds through a small mountain of paperwork with your name on it, it’s all for you.  But there’s some light at the end fo the tunnel: The 1st holds a special surprise.

Sagittarius

Ever compassionate, Sagittarius will find their more tender side coming front and center this week. Take advantage of this added empathy to focus on communication: even the most disagreeable, treatment-resistant patients will be more likely to listen to you now.  It’s a great time for romance, too, although you’ll want to think about that after work hours.

Capricorn

They tell you to trust your gut — and here you are with IBS!  Don’t let doubt get in your way, particularly when it comes to making difficult decisions. You’ve got wisdom, insight, and intuition: use this week to practice trusting your judgement.  This is particularly true on the 28th, when you may be needed to make a difficult call.

Aquarius

Money concerns loom large this week, but that’s no problem for a creative nurse, right Aquarius?  One simple kidney fetches big bucks on the black market, and a lot of patients still have two…of course, if you want to stay on the right side of the law (which we strongly recommend!) you can try keeping the spending under control instead.

Pisces

Slow and steady wins the race, Pisces!  You’ve won the nursing lottery: a week that promises to be slow, steady, and routine, routine, routine.  Wouldn’t that be a wonderful change of pace?  Make sure you don’t get bored.  The calme continues until the 28th, which will deliver change in a big way!

• Medical daffynition: Testicle (n.), a humorous question on an exam. #

• Medical daffynition: Flatulence (n.) the emergency vehicle that picks you up after you are run over by a steamroller. #

As part of the admissions procedure in the hospital where I once worked, I asked patients if they were allergic to anything. If they were, I would print it on an allergy band placed on the patient’s wrist.

Once, when I asked an elderly woman if she had any allergies, she told me that bananas made her lips swell.

Imagine my surprise when, several hours later, the woman’s irate son stormed up to the nurses’ station and demanded to know, “Who is responsible for labeling my mother ‘bananas’?” (more…)

Jack: “My brother was sick and went to the doctor.”

John: “Is he feeling better now?”

Jack: “No, he has a broken arm.”

John: “How did he break it?”

Jack: “Well, the doctor gave him a prescription and told him no matter what happened, to follow that prescription. And the prescription blew out of the window.”

John: “How did he break his arm?”

Jack: “He fell out of the window trying to follow the prescription.”

As a student, I was assigned to a patient: after a bed bath, it was time to get her out of bed. Try as I might, I could only find her right shoe. A fellow student who walked into the room found me on all fours, looking under the bed for the elusive second shoe.

I told her what I was doing, and then it hit me. The patient had a left AKA!

By Amy Nemetz

I don’t think I like this business of changing the name “nosocomial’ to “health-care-associated.” Yes, I get the point: to also include all health care settings, and not just hospitals, under one heading. But see, first of all, this new name is in plain old, you know, English! Health care consumers can even understand the term, which is supposedly the exact opposite goal of medical lingo. And worst of all doesn’t the term say outright, in that plain old understandable English, that basically we health care providers messed up?

You never hear patients, including your Aunt Helen whose gall bladder was removed last January, talking about their ‘nosocomial infections.’ They may know they ‘got an infection in the hospital,’ and maybe even realize it’s sort of related to the hospitalization itself. But that’s it. ‘Nosocomial infection’ is—oops I mean WAS– a term kind of shrouded in mystery. Thank goodness for that.

But now? Good grief! It’s like we’re announcing that it’s our fault!! “Health-care- associated- pneumonia?” We may as well wear t-shirts proclaiming “I am carrying germs right into your lungs.” It’s telling the entire mankind that we, members of the most highly thought of and trusted professions in the world (at least until now), are the cause of these bugs.

I can already see the guy with the stuffy nose in bed 3052– who really only came in with intractable back pain but now has this uncomfortable nasal congestion that we all get every allergy season, now telling all his friends and neighbors and maybe even his lawyer that he has a “health-care-associated pneumonia.”

Boy am I glad I have my own malpractice insurance. I suggest you get your own.

Granted, I may have once or twice been the source of a nosocomial– I mean healthcare associated- infection or two myself. I really never told this to anyone before, but once we’re announcing this health-care- associated pneumonia bit, I may as well be the first to give my confession: I definitely recall only scrubbing my hands vigorously for only 14.2 seconds instead of JCAHO- required 15 in between taking the BP of the guy in E.D. Room 3 (c/o sprained arm r/o fx) and checking on the lady in bed 8 (c/o cephalgia).

Who’s next? Come on, it’s coming out in the open anyway. Let’s all let our hair down. (Although loose and/or long hair breeds germs and should really be kept short or pulled back away from the face.)

And now that the world will be hearing that “health-care-associated” infection bit, you can imagine what will be going on in hospitals health-care-associated sites now. Patients will be suspiciously studying every single health-care-associated staff member. Not just the nurses and MDs and CNA’s but now every housekeeper and mop, every dietary worker bringing trays and clearing them off, maybe even the volunteers bringing their mail. Can’t you see these patients tucking details in their heads as they mentally note, “Thaaaaaat’s what’s causing all this ‘health-care-associated pneumonia’ I hear about. That volunteer just delivered my get-well card–without gloves!!”

Actually, once we’re embarrassing ourselves and being completely honest with this confessional new term, let’s go all the way. That physician who doesn’t wash his hands between one patient and another– and you find it unsurprising that his patients get MRSA more than the rest of the unit….well, we could name the infection “Dr X- acquired MRSA,” but there’s always that libel and defamation of character suit. (Which is probably not covered under your malpractice insurance policy.) How about ‘poor-handwashing-technique-acquired infection?’

How about some other stuff we see– will they be named things like “Poor-suture-technique associated wound dehiscence?”

And what about us? How about ‘insufficient-betadine–pre-Foley-insertion -associated UTI?’ ‘Faulty -IV-technique-associated phlebitis?’ And something a few of my own patients might have suffered during my first six months out of nursing school: ‘Poor- injection -technique-associated ecchymosis?’

Then again, maybe it wasn’t my fault. Some of them- especially those geriatric ones- were really “insufficient -subcutaneous- tissue- associated ecchymosis.” That’s better. See, it’s not always the fault of the health-care- associated-providers, is it?

And waittttttttttttt a minute. Now that I think about it, lots of conditions are not our fault. Why do we have to be honest about our health care flaws, but the patients don’t have to be? Why can’t we ALL be honest here? Patients included?

For example, I think it’s time for a NEW classification of MIs. ‘STEMI,’ ‘Non Q,’ ‘Subendo,’ ‘anterior wall,’ blah blah– outdated. Let’s go for it: The guys who sit home for 3 days not believing it’s an MI: Denial-associated MI. The chain-smoker who eats at McDonald’s every day for lunch after breakfast at Burger King– is Unhealthy-lifestyle-acquired MI. And the poor folks who really take care of themselves but have MIs mostly because of family history: “No- fair- it’s- only-DNA-associated MI.” Insurance companies could have a FIELD day with this.

OK well, um,………So maybe this idea is NOT a good thing. Well, then….. how about making up a NEW term that would include all health-care-associated-settings, without publicly humiliating ourselves? Let’s think. Um, well….. maybe some acronym or something? Oh hey, I’ve got it! How about “NOSOCOMIAL?”

Now they’ll all be happy at JCAHO (Just Clean All HOspitals), and HCFA (Hospitals Cause Fevers and Ailments). Oops my mistake– I think the idea was the CDC ‘s(Caregivers Don’t Contaminate). Of course we still get to keep that nice mysterious hard-to-understand-and-even-spell ‘nosocomial’ term, and no one will know what it stands for, except us. You know, the guilty parties. Nurses/Nursing homes, Offices/Outpatient Settings, Other Caregivers Or MDs Infecting ALL.’ See, that’s more all-encompassing.

Those of you who read last months JNJ submission* are inquiring… So what qualifies you to teach us how to handle cranky physicians anyway? Are you a shrink?

Au contraire, mon frère. The other end. The south end of the proverbial north-bound horse. I am, in fact, a gastroenterologist. And yes, I know all the ass-ociated jokes.

 The only physician who starts at the bottom and stays right there.
 A job where there are plenty of openings.
 A doctor who puts in a hard day at the orifice.
 A rear admiral…standing on the poop deck.

Out of your system now? However, I am always delighted in any ‘pull my finger’ humor that you may regurgitate. And if you are behind on your colon cancer screening, I would be happy to rectify it. (more…)

REPORTS FROM THE FRONT LINES OF THE GENDER WARS, ADDRESSED TO NURSES AND THE PEOPLE WHO LOVE THEM. SERIOUSLY RECORDED—WITH TONGUE (DEPRESSOR) FIRMLY IN CHEEK—FROM GREG GODEK, AUTHOR OF THE BESTSELLER 1001 WAYS TO BE ROMANTIC.

Valentine’s Day Revisited.

Nurses want to make the world a better place, right? Okay then . . . Would you like to sign our petition? We’re trying to collect a million signatures in an effort to create a national holiday devoted to love.

You say we already have Valentine’s Day? Well, we hate to be argumentative, but Valentine’s Day isn’t really a “holiday,” now, is it? (In our dictionary, a “holiday” is defined as “a festive time of no work; an officially sanctioned day of leisure and pleasure, usually devoted to a specific concept or celebration.”)

We believe that Valentine’s day is, at best, a pseudo-holiday. Something that our culture pays lip-service to, but that we don’t really take seriously. You know, like those other “holidays” such as Flag Day, Arbor Day and Ground Hog Day.

We believe that since most people hold “love” to be their highest value, there should be a special day of recognition devoted to it. You know, the way people value over-eating on Thanksgiving; and the way we pay homage to shopping on Christmas; and the way we celebrate explosives on the Fourth of July. Love should rank right up there, don’t you think?!?

So please consider signing our petition. You just might help change the world.