Dear Doctor.

Letters I wish I could write, but never will.

#1

Dear Doctor Dumbass,

I realize in your three years of residency that you have seen and taken care of many patients with syncopal episodes. I know it in fact. But why this time, in spite of report that the patient lost consciousness for a full minute as he DFO’d, and not because he hit his head, did you write his activity to be up “ad lib”? You’re lucky us nurses can think for ourselves and suggested to your patient to stay in bed until we got him a little more rehydrated and then get out of bed, but only with help.

We know and understand that this is a small concept, but we’re big fans of patient safety and having someone pass out on you tends to sour our night. We would rather not have to scrape your patient up off the floor they hit as they passed out and fell. And honestly, the incident report takes far too much time to correctly fill out. Time that is spent saving patients from themselves.

Thank you,

Your Floor Nurses.

#2

Dear Doctor Asshole,

We would like to apologize for dragging you out from your peaceful slumber in the resident’s quarters when we called an RRT on a patient that needed a little extra special attention. We could tell by your rumpled clothes, lack of spark in those half-shut eyes of yours and the sheet impressions on your face that we had roused you from a good night’s sleep; and we apologize.

That said, do not treat us like shit. We have the right, no the responsibility to call a RRT for whatever reason, especially if we feel our patient is having an acute decompensation.  We are doing our job.  Do not belittle us by yelling over the presentation to you saying, “Why did you call an RRT?” with a sneer on your face and dismissive tine in your voice.  While we wanted to say, “Just to wake your sorry ass up,” we didn’t and pointed out the patient’s labored and frothy breathing, the patient’s heart rate of 170 (one which your colleague Dr. Dumbass hadn’t placed on tele on admit) and SPO2 in the 80’s with a NRB mask on. We asked for your exalted guidance and inspiring leadership in a tense situation made only tenser by the fact you are a fuckwad, who speaks to family, the husband of the poor woman about to buy herself a tube, the man who has stood by her side and cared for her every moment of her end-stage Parkinson’s disease, who bought all the necessary equipment, including a Hoyer lift, to care for her at home, lambasting him about his decision to keep the love of his life a full code, in spite of her terminal condition. Refusing to believe him up to the minute where that man tells you to, “Intubate her.”  Love drives us to do what many see as irrational things, but it is not our place to judge, especially in front of the loved ones.

And by the way, with an EKG with a rate of 150, those little triangular deflections in the EKG are not P-waves, see how regular they are? See how they merge into the QRS complexes? Yes, Dr. Asshole, that is a textbook example of 2:1 atrial flutter, not sinus tachycardia. It’s sad that the lowly floor nurse can spot that and you can’t. It also really sucks when your attending tells us that you were wrong and we were right. We’re sorry that you are trying to make up for some obvious lack in your life (may I say manhood…?) by being a complete dick to everyone around you. It will not win you friends. We will chafe under you ham-handed management and surly attitude (I mean really, you aren’t a surgeon or cardiologist and don’t have the chops to back that attitude) until management gets the hint that you are more of a hindrance than help, if only from the sheer volume of write-ups with your name on them.  Until then go find something else, may we suggest a 2-seat convertible, to fulfill your manliness.

So pardon us for being frank, but we figured you needed to be taken down a notch or two.

Thank you,

Your Floor Nurses.

Passive-aggressive? Maybe a little. The sentiment is there though. Two stellar examples we shown to me this last weekend. While it may not seem like a lot, it is a trend of things with these two. You just scratch your head and do your best for the patient and family.  Keep them safe and as the wise man once said, “Air goes in and out, blood goes round and round; any deviation from this is bad,” we try to keep that premise, everyday.

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