Nurse Marge In Charge!

Nurse Marge might not have all the answers, but after *ahem* years as a RN in some of the nation’s toughest hospitals, she sure knows how to make up something that sounds right! We get lots of questions here at JNJ, from nurses looking for advice and guidance and Nurse Marge has graciously agreed to answer them for us.

So with that, let’s turn the floor over to Nurse Marge!

Dear Nurse Marge,

I’m a new nurse, having just graduated in December and finally landed a job. The problem is this: I’m young (23) and I look even younger than that. I mean, I get proofed to buy lottery tickets! This is turning out to be a problem: no one at the hospital is taking me seriously. Not the doctors, not the other nurses, and not even the patients! Last week, I had one of them ask me to ‘go get a grown up to take care of my Mother’!

Yours, Too Young in Three Rivers

Dear Too Young,

This is a problem? That I should have such problems! I’ve got uniforms older than you…

Seriously, the nice thing about this issue is that it’s self-resolving. You may look young now, but trust me: two years on this job, and you’re going to find yourself being offered senior citizen discounts when you go out to eat.

My advice? Take them. 10% off all these meals adds up!

If you don’t want to wait for the stress induced gray hair to mask your lack of years, here’s some tactics you can take to make your fellow nurses and the occassional doctor take you more seriously. I can’t promise this will work on every doctor, I’m a nurse, not a miracle worker!

First, it’s all about the attitude. If you want to be taken seriously, you have to act seriously. Confidence matters — a lot! Bear in mind that some of your fellow nurses were once in the same boat you are in now: we were all new nurses once. Of course, for some folks, that might mean they’ll have to stretch their mind back to the dark ages to remember that fact — but it’s true, never the less!

Second, the trick to a long career as nurse is to never miss an opportunity. When you’ve got a patient requesting a ‘grown up nurse’ — go find them one. Trust me, that’s not a patient you’re going to enjoy dealing with. Why not make them happy and hook them up with someone of more advanced years than you? Of course, if that nurse you find happens to be the one who gives you the roughest time about being the new kid on the block, well, some lessons just keep on giving, don’t they?

Simply smile, tell them the patient wants a grown up, and ‘You’re the most grown up person on the floor!” I’m sure they’ll be thrilled.

Good Luck!

Nurse Marge

Have a question for Nurse Marge? Simply email it to her at Cindy@journalofnursingjocularity.com and our fearless editor will pass it along to her! Chances are good she’ll answer it in an upcoming column. Nurse Marge in Charge updates every Monday.

Also: Our lawyers insist that Nurse Marge’s advice and opinions are only that — advice and opinions. Use them at your own risk!

Nurse Marge & The Bad News

Nurse Marge in Charge

Dear Nurse Marge

I’m hoping against hope that you can help me, Nurse Marge, because I absolutely DO NOT know what to do.  I’ve been a ER nurse for 12 years, so it’s not like I’m inexperienced here, but this situation has me banging my head against the wall.

Here’s the situation. It’s very late Saturday night — very early Sunday morning — and then we get a patient who’s had a very bizarre gardening accident.  It was the type of accident that left the patient with a large cucumber lodged within her backside.  This is why you shouldn’t weed the garden at night, apparently.

But here’s the thing: the patient just happens to be married to my husband’s business partner.  She actually didn’t  SEE me, as far as I know. (She had her face buried in the pillow — and who could blame her?)  I handed her chart off to a buddy, and moved on to another patient, who thankfully had steered clear of the produce aisle.

But here’s the problem.  While the patient didn’t see me, I know for an absolute fact that her husband DID.  He instantly recognized me (we socialize with this couple regularly!) and his face went so red he could have doubled as a sharps container!

I haven’t said anything to my husband…but you know we’re going to wind up hanging out with this couple SOON.  How in the world do I handle this?

Signed,

In a Pretty Pickle!

Dear Pretty Pickle,

For once, HIPAA is your friend!  There’s really nothing you can do in this situation EXCEPT pretend like it never happened.  You saw nothing, you know nothing… you certainly SAY nothing!

Of course, this only works so well.  You know what happened, and THEY know you know what happened.  They’re likely far more mortified by the incident than you’ll ever be.  Make it easy to move past this incident by avoiding conversations or situations that could make them remember what happened.  That’s what  a good friend would do.

For example:

Under no circumstances host a garden party this year.

If you’re having dinner with this couple, it’s okay to decline seconds — but don’t do so by saying, “No thanks, I’m stuffed!”

Avoid the farmer’s market, at least while  you know they’ll be shopping.

It’ll take a little while for this situation to fade from memory — yours, at least — I don’t think SHE’LL be forgetting this incident, ever — but if your friendship is strong enough, and you keep silent and professional at all times, eventually you’ll be able to put the whole incident behind you.

As long as you don’t give in to temptation and buy them a Salad Shooter for Christmas.

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

What do you say to patients when they ask “When are you going to become a doctor?” I get this all of the time (it might be because I’m a male nurse but some of my female colleagues get it too!) and I never know what to say!

I’m Good With Being a Nurse, Thanks!

Dear I’m Good With Being a Nurse, Thanks!

Immediately after my lobotomy.

That’s my answer of choice, although you have to be careful not to share it with patients immediately in front of a doctor! The public doesn’t realize that nursing is a highly skilled profession; any opportunity we’re presented to change that image is a good one — provided, of course, you’re not doing any of the seven million other things that come into the typical shift, including the channel-changing, pillow-fluffing, call-light answering, family-member herding that appears to be the lion’s share of the day and that trivial nonsense of saving people’s lives.

I turn to you, my readership: I know you’re funny folks! What do you say when people ask when you’re going to be a doctor?

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

I’ve got a question for you: cap or no cap? Some of the older nurses I work with say wearing a cap made the patients treat them with respect, while others say they were nothing but a pain in the you-know-where. I’ve never seen anyone actually *wearing* one so maybe they were more inconvenient than they’re worth — what do you think? I’m more than half tempted to get one, but I love that retro style!

Cap Curious

Dear Cap Curious,

There’s a school of thought that says an all white uniform, with the hose and cap and pin, created an impression that absolutely demanded respect. Of course, none of the people who say that are actually old enough to have worn that regalia — or if they are, let’s just say that the years elapsed have allowed a pleasant fog to obscure the fact that while our clothes have changed, our patients have not. The patient who says Thank You and is a joy to work with is still the same — and the obnoxious type that wants to feel you up doesn’t care if you’re wearing nurse white or pediatric purple panda print: they’re going to grope whatever they can reach.

Like the old school look? I say go for it — but don’t forget to celebrate the freedom you have to NOT wear that cap as well. The respect our profession commands comes not from our uniforms but from our performance, and that’s what really matters.

Well, that, and the fact that managing the laundry is much easier when everything’s not white.

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

It’s the strangest thing: The nurses I am working with keep getting younger and younger! I’ve only been a nurse a few years, which means I have the *same* amount of experience on the job as my colleagues, but I have decades worth of life experience that they don’t yet. It makes things weird: I’m having a really hard time ‘fitting in’ with my peers, who are just getting married, starting families, and so on. How should I handle this?

Signed: The Old Lady

Dear Old Lady,

Don’t sweat it: those young whippersnappers are getting older every day! In time, they’ll realize the same benefits you have right now: a greater sense of understanding what your patients are going through, experience dealing with the many different types of people who are related to or visiting your patients, and the sure knowledge of exactly what motions will make your sore back already worse.

It doesn’t matter if you don’t have a lot in common with your colleagues right now:those bonds and commonalities will develop as you work together. It doesn’t matter if your fellow nurse has a toddler and you’re a grandmother — when you’re covering the patient who just doesn’t understand that getting out of bed right now is the worst possible thing he could be doing, you’re going to bond. Look for those opportunities to laugh together: they’ll show up every shift!

Rather than shy away from the age difference, use it as a way to create humor. I tease some of my colleagues about being younger than my nursing cap — heck, I tease ALL of my colleagues about being younger than my nursing cap — and they ask me if Jean Watson was really that saintly in person!

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

I’m back to work after having my first baby. He’s perfect, 8 weeks old…that’s not the problem. It’s me. I seem to have lost my mind. I can’t remember ANYTHING. We’re talking perpetual brain fog here. My colleagues say it is common. That I shouldn’t be worried. That this happens to every new mother – but I’m petrified I’m going to make a med error or other mistake. What can I do?

Brain Fog!

Dear Brain…What did you say your name was again?

I don’t want to make light of what’s happening to you. The baby brain fog syndrome is very real, and very troubling, especially for nurses. There’s so much we have to remember, and such serious consequences if we forget.

The thing is, it doesn’t get better. Wander around your unit, and listen to your nurses. Some of them have children who are thirty years old, and they’re still looking for the whatchamacallit they left by the thingie; not the white thingie, the blue thingie.

Chances are, you know exactly what they’re talking about, and you can help them find it. This is because they’re in an advanced stage of what you’re experiencing now; where you move past the discomfort of not remembering things and learn how to get things done anyway. You’re not losing your memory, you’re gaining a new way to view the world.

There’s a name for this, but I’ve forgotten what it is.

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

I need your help. I’m a new nurse, and it’s the greatest and hardest thing I’ve ever done. That’s not the problem — I expected it to be rough, and it is, but I’m getting the hang of it. What I’m not getting the hang of is dealing with my family and friends who totally dismiss what I do. When I come home from a rough shift, my boyfriend (who is a mechanic) says, “What did you expect? You signed up to be a professional ass wiper.” I hear all the time that all I have to do is what the doctor says — how do you explain that half our job is saving people from the doctor? The continual disrespect is getting me down!

Nervous in Newburyport

Dear Nervous,

While I normally say ‘civilians’ never get what nurses really do, and we have to understand that, as part of our caring, therapeutic approach to humanity, I think you should totally ditch the boyfriend. Tell him that since you’re a professional ass wiper during the day, you don’t need any asswipes at home, thank you very much.

Make sure your car is running really well, first.

The problem with our profession is that there are so very many stereotypes attached to it. From the saintly types who ease pain, wipe the fevered brow, plump the pillow and regard family members as a gift from Heaven and physicians as being even better than that — mind you, I’m telling you this secondhand, for in 38 years in the business, I’ve never once met a nurse like this. I came close once, but she was lifted away on a bower of fluffy clouds before my presence could spoil her for the profession forever — to the pill-popping, pharmacist-shagging TV star — which I’ve never understood, since I can’t even get critical, life saving medicines delivered in a timely fashion, how in the world will this guy be in delivering anything in the vein of satisfaction before I age out of giving a damn about such things? — to the sex goddess in a short, tight white uniform and a nurse’s cap almost as pert and perfect as her bosom?

I admit that that last one is entirely my fault. Sometimes we don’t really know the impression we make, you know?

Anyway, back to my point here, which is, not only are you working against the basic misconceptions people have about nursing, you’re working against the mythology of nursing.

Well, I say fight fire with fire. If we don’t like the myths we’re dealing with, let us create our own. Let us sing songs of the Crash Cart Company, saving lives and singing show tunes! Tell the tale of Blood Pressure Bonnie, who can check vitals in the wee hours of the dawn without disturbing a single patient. We must not forget Advocacy Annette, who reminds residents that maybe they want to think through that order and saves the day!

That’s what we should do. Make sure you let me know how it turns out!

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

What do you do when you get a CNR — a crazy nurse relative? This person shows up to visit their Mother or Sister or Great-Niece’s Best Friend’s Babysitter’s Mother, and they not only tell you everything they think you’re doing ‘wrong’ but they give the patient medical advice that might be accurate on Planet Completely Insane but not on Earth. These people drive me NUTS but you can’t be rude.

Freaking Out in Fresno!!!!!

Dear Freaking Out,

Chill. There’s a secret to handling these people, and I’m going to tell you what it is.

Treat them like they’re your colleagues. Right now, I guarantee that you work with a nurse who maybe doesn’t have the most up-to-date, accurate information about every specialty under the sun. Maybe one or two of them are convinced of things that are completely wrong. Maybe your work place is completely different than mine, but I have at least one colleague who thinks reality is a nice place to visit, but has absolutely no plans of staying.

You have to tactfully, efficiently handle these people, and they’re not even stressed to the eyeballs about the sick person laying there in the hospital bed. I mean, they could be, depending on the patient and the situation, but they’re not personally involved in, the way the CNR might be. So tap into that skill set, and remember that we’re all people too.

Or, failing that, ask them directly what kind of nursing they did. Then at least you’ll know what you’re dealing with. A wide range of people self identify as nurses, and you want to know if you’re dealing with a retired school nurse or the volunteer who was in charge of stocking the emergency first aid kit at Vacation Bible School for four weekends in a row.

If that doesn’t work, run screaming from the room. It’s an amazingly useful technique for so many situations!

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

What do you do when someone asks about your politics? Health care reform is topic #1 around here, and I REALLY don’t want to get into discussions with patients about it!

Nervous in Newark

Dear Nervous,

You’ve got two routes here. Actually, you’ve got three, but the third is to fake a grand mal seizure, and that is really only useful on special occasions. You can’t do it with the same patient more than once.

So the first route is the noble non-answer. Nurses are really good at this, and people buy this answer, because they believe in our self-sacrificing nature. Simply say, “I’m not worried about the politics, I want what is best for my patients.” Smile and then QUICKLY, before they get a word in, say, “And what would be best for you right now is if we looked at this festering head wound…” or whatever the presenting issue may be.

That isn’t actually what I do, but you could do it. It has, in fact, been done. What I do is tell people about my ismectomy. Ismectomy (pronounced is -im- ec- toe- mee) is a rare but useful surgical procedure in which a skilled neurosurgeon removes that portion of your brain that allows you to voice political opinions. When you try, that signal in your brain re-routes, and you find yourself uncontrollably lashing out with extreme physical violence at the people nearest you. It’s a form of aversion therapy that stops people from asking you further questions. Sometimes, of course, injury results. That’s unfortunate, really, but it does stop me from getting into uncomfortable conversations. I simply explain that, and then no one wants to know how I feel about health care reform.

Ismectomy leaves no scars, anywhere, so it’s very hard to tell who has had one, and who is just pretending to have had one. I’m sure they’ll get right on legislating that very issue, just as soon as this current mess is sorted out.

Good Luck!

Nurse Marge

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