Nurse Marge in Charge

Dear Nurse Marge,

The parking at our hospital is terrible. There’s not enough spaces for all of the staff, never mind patients’ families and visitors. It’s been this way for the entire five years I’ve been here, and from all these memos I’m reading about cutting costs and conserving supplies, it’s going to be that way for the foreseeable future. It’s not going to change.

Don’t Blame Me! I Bike!

Dear Don’t Blame Me!

Your instincts are right on, and I want to congratulate you on attaining one of the most important Nursing Skills: The ability to choke off the automatic response that any normal, sane person would give to an inane question.

You might want to try using some of your other nursing skills to address this question. Restating is particularly helpful. Try saying, “I hear you saying that you had a difficult time parking today.” Follow this up with other helpful observations, such as, “The sun appears to have risen in the East this morning!” and “Would you look at this? This glass of water is full of wet stuff!” can provide valuable reinforcement of the basic concept, and help with both comprehension and retention. It’s important that we provide this type of patient education — and people are so very grateful for the insight!

Empathy and limited self disclosure can help. State that you commiserate – and up the ante by sharing how far away you have to park, regularly, in order to make it to care for their relatives and friends. “Sixteen blocks! And there are no trains — not even a cab! You have to run the whole way! Uphill! And bears chase you! I’m not sure if they’re rabid, or if that white foam is just residue from too many Danskins chewed to bits!” It won’t make your visitor feel any better, but it will keep them entertained, and as we know, entertained visitors are visitors who put positive comments on those helpful survey cards that litter the place like so many self-referential doilies.

Learn from the MD’s: When they don’t know, they call in a consult! When that visitor stops you, immediately call in the head of buildings and grounds and perhaps the director of development. Together, you could address that pressing concern — or at least convince the powers that be that some signs addressing the parking situation should be hung sooner rather than later!

Good Luck!

Nurse Marge

Nurse Marge & The Bad News

Nurse Marge on Preventative Care

Nurse Marge in Charge

Dear Nurse Marge,

Did you ever have one of those days where just every thing went wrong? That was my day last Friday. Two family members got it in their heads that Grandma — who’s 95 and so immobile she needs assistance to change her mind — needed to take a stroll around the grounds. Of course they drop her while attempting to wrestle her to her feet. Off she goes to the ER with a broken wrist, fractured pelvis, and a mountain of paperwork. I missed it because I was prying Mr. Z — who has voyeuristic tendencies and a pretty good case of dementia going on with his gi issues — out of Miss S’s room, all the while she’s screaming that the Cossacks were coming to get her.

Signed,
Calamity Jane

Dear Calamity Jane,

Your NM is right — you should have a plan, at all times, for all occasions. I personally find great comfort in the sound of breaking glass — which happens every time one of those plans goes right out the window. And of course, a broken window creates an escape portal the athletic nurse can use to put valuable distance between herself and catastrophe.

Maybe that’s where your student went! I’d keep an eye on that one. The ability to vanish exactly when they’re needed the most — that’s administration material right there. She might be your next DON!

Unfortunately, there’s no plan that will stop visitors from being visitors. Tell your NM that instead, you need a change in institutional policy. Borrow one from retail: You break it, you bought it! That way, when they drop Grandma, they can put her back together!

Try talking to your NM about having only appropriate patients sent to your unit. You wouldn’t have to worry about Mr. Z that way — or, more likely, you’ll send your NM into uncontrollable hysterics. If she can’t get the laughing under control, you’ll get a new NM, who doesn’t know anything about your very bad day — nor the plan you were supposed to have to avoid it!

Good Luck!

Nurse Marge

Nurse Marge in Charge

Dear Nurse Marge,

I’m a new nurse grad and after a year found a job. I work in an ambulatory surgery center, and there’s only the four of us, plus A., the ‘head nurse’. It didn’t take me too long to get the hang of things, I thought — but you wouldn’t know that from A. She criticizes everything I do — but she criticizes everything everyone does, and my fellow nurses say “That’s just how she is, you have to let it roll off your back.” How do I learn how to do that? I thought I’d get used to it, but its been months and it’s still driving me crazy!

Stressed Out

Dear Stressed Out,

The thing you have to do when dealing with criticism is consider the source. Are you getting harsh words from a patient in pain? They’re having a rough day; it’s easy to let it go. Have one friend who is sure your life would work so much better if you’d only do things her way? Who are you kidding, nurses never have time for friends anyway. Have a boss that constantly rips you apart but is integral in keeping your job? That’s the type of criticism you have to learn to ignore.

Some people will tell you you should listen to criticism and use it to improve your performance. These people may have a point, but you haven’t listened to them thus far, so why waste time thinking about that now? Besides, ignoring is a lot less work than self-improvement. You have to maintain your perspective here.

You don’t want to ignore people too overtly, especially if they’re in power. Do that, and they’ll make it even easier for you to ignore them, and that’s no good! So master the art of the smile and nod, the parrot response (you say back to her what she’s said to you, spinning it just enough so she thinks you think she’s a genius), and the artful dodge — the careful dance of being conveniently out of sight most of the time. Look to your colleagues: they are surely masters of it!

Earplugs are good too — especially if they’re really small!

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 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

Nurse Marge Discovers The Problem With The Internet

Nurse Marge in Charge

Dear Nurse Marge,

I saw you were talking about some of the pros and cons of being married to a nurse, and I had to share this little tidbit. You see, my husband of 25 years is nurse, and he’s getting to that age where really he doesn’t like to do anything he doesn’t want to. I was working back to back doubles one weekend, and when I left for work, he was seated in his recliner, in front of the TV, remote in hand, some chips and soda strategically nearby.

Not a Newlywed Nurse

Dear Not A Newlywed,

Did you see the new Nerf six-shooters? One on each hip — it gives you a dozen shots at a go!

Water guns aren’t bad either — and you already have all that ‘ammo’ inside your back door!

Good Luck!

Nurse Marge

Nurse Marge on The New Staff Recruitment Package

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