Under My Skin

It’s not often that I get riled up by things patients do thanks to a dedicated sense of Zen and a well-developed ability to shrug things off. So it’s a big deal to me when I let someone get to me.

Someone did the other night. I know rationally it’s not a big thing, in fact it happens fairly regularly. But deep in my psyche it stung and I’ve been perservating over it since. I got fired by a patient.

It’s happened before, it will happen again is what I keep telling myself, but it nevertheless unnerved me. Why? The reason? It was because I’m a man. Or as I crassly put it on Twitter, “I got fired because I have a penis.” It’s one of those things us men in nursing come up against and we have learned to take it in stride. There are ingrained social and societal mores, stereotypes and prejudices that cannot be erased in the first five minutes of you meeting me, the male nurse.

Rationally I get it. Emotionally/psychologically I don’t.

If you’re a 80-something year old lady, having a male nurse is probably a bit out of your comfort zone and no matter how professional the nurse is, it still isn’t comfortable. But I don’t understand totally. If you’re that age, odds are good, like 100%, that your Ob/Gyn was a man. You let them view and examine your holiest-of-holies, but when it comes to the nurse, the one who ensures you get the right medications, that the treatments we are doing is actually working,  it’s just too weird. I’m not asking to examine your bits, in fact I want nothing to do with them.  I even offered that if you were uncomfortable I could have our aide help you with your bathroom needs. Clueless I’m not. I can tell when things are not quite right and take preventative action, so I thought I had it covered.

Yeah, I was a little surprised when a family member came out to the nurses station and spoke to a co-worker about it. Not to mention I was sitting right there. My name was on the patient’s board and I was the only guy sitting there. They didn’t talk to me because they were ashamed, but here’s the thing: I wouldn’t have been so upset if they had asked me about it. In fact in I would have offered to swap assignments on the spot, no muss, no fuss, no dirt off my shoulder.

We swapped out assignments and solved the problem

Here’s the thing too, they commented to the nurse who replaced me that it wasn’t my ability, but merely my gender as the reason to swap.  I’ll take that.  More though, I was angry.  I was angry because it wasn’t my skills, my attitude or inter-personal skills, it was that I was a man.  It’s accepted because of this, but what if it had been because I was black, or gay, or Muslim?  I’m not truly making comparisons and saying I’m being oppressed, I’m trying to make a point.  Prejudice is still prejudice.

I will agree that there are some places men shouldn’t be nurses.  Hell, I’m guilty about it since I had a little bit of problem with my wife having a guy nurse in OB, but I never would have asked to change (and in that case only because he was incompetent.)

I had thought at this point in time the acceptance of men in nursing this was a non-issue.

I was wrong.

As I said above, it’s happened before and will happen again. But it still doesn’t make it right.


Addendum:  I’ve let this post simmer for awhile and while I’m not as pissed as I was, it still irks me.  But I tell myself, “get over it.”  And it works.  Most of the time.

Who Cares if I’m Gay or Not?

Can We Stop the I’m-a-Male-Nurse-Who-Isn’t-Gay-Contrary-to-the-Stereotype Routine? « Those Emergency Blues.

Awesome piece!

It’s what I tell my patients:  I am a nurse.  My gender/sexual orientation/going to be a doctor, all of that bullshit means nothing.  I am a nurse.  A professional, educated and capable.  I am a nurse.  Just so happens to be that I’m a man.

And it doesn’t matter.  I am a nurse.

Naked Time!

Nothing dirty here, just a rumination of nakedness in the hospital.

You know it’s not going to be a good night when the first thing you do is forcibly re-direct a naked man out of the hallway and back to his bed.  Even though he was suffering from a nasty case of Versed-itis© (odd, sometimes insane behavior in normally sane and calm people as an adverse reaction to Versed), he was jumping out of bed post-angio and running into the halls naked, as we were trying to keep him safe.  It’s always fun when the doc is yelling for some help as she is being chased by the naked dude in his nude adventures.

It gets better when the IV nurses comes out of a room and says, “Yeah, thanks.  I just saw your patient’s penis.  Oh, and he tried to come on to me.”  That’s a surefire way to ensure no one bothers you the rest of the night.

Perhaps the best is when the naked chick is running around the unit doing laps, with a nurse or two chasing her with a gown and sheets.  It’s pretty damn hilarious.

What is it about the hospital that promotes nakedness?  Could it be the drugs?  Could it be the lowered inhibitions due to neurological decline?  Could it just be that they don’t care?

Lucky for me it’s been all three.  There was the psych patient in with syncope that the residents stopped all the anti-psychotics on thinking they were contributing to the syncope (turns out it was the the pauses he was having) but he ended up naked every night, roommate be damned.  There have been several cases of drug-induced nakedness, like angio boy.  And the neuro decline brings to mind the Huntington’s patient who slept naked and would jump out of bed to run to the bathroom, except sometimes he got lost heading there and ended up in the hallway.

99% of it has always been guys though.  It’s like we’re so enamored of our own bits that we need to show it off to the entire world, whether they want to see it or not.   If it’s in the rooms, I could care less.  Like the dementia patient who’s wife told us they had slept naked for years, it was comforting to him and once we got the clothes off, he slept like a baby.  It’s been pretty rare to have a female streaker.  I guess the societal mores are too deeply embedded in them (they just tell you about their need for a new vibrating friend…).  But when the lights go down at the hospital, too often the clothes come off.  And not in a Grey’s Anatomy-way.  Some will argue that this is just part of nursing.  It is.  A damn funny one!

I know however, that when I’m of the age and in the hospital, I’ll be the one running naked down the hall, freaking everyone out!

One Shift

I stumbled upon one nurse’s account of day in his life and thought, “Hey, I could do that too!”  Not that my days are all that interesting, but it’s good blog fodder.  The big difference is that I work nights and kind of see myself as a “clean-up batter.”  Original stories here: New Nurse Insanity.  via A Day in the Life of a Nurse.  Here goes…

1500: Wake up with a start, stare at the clock until my eyes focus enough to make out that it is on 3 o’clock.  Roll over with a sigh and try to go back to sleep, trying to ignore the bright sunlight outisde my bedroom window.

1615: wife comes in to make sure I’m awake, as she’s doing so the alarm clock goes off, again.  Crawl out of bed, last night really kicked my but, 5 admits, down 1 nurse and I’m feeling it in my back today.  Shower, find scrubs and load to-go bag.  Add a pair of Tylenol to my normal “morning” meds.  Feeling human, kind of.

1640: Downstairs to eat.  Hmmm, it’s looking pretty bare, guess we need to go shopping.  Add that to the list of things to do.  Eat, top off waterbottle, grab lunch, to-go bag and head for the garage.

1715:  Out the door with my bike.  My wife and I walk to end of the block and talk about our days.  She asks how last night was and sympathizes with my tale of woe.  Start riding my bike to the train station.

1725:  Dumbass in a hurry nearly sideswipes my off the road.

1745:  On MAX train into town.  Zone out trying to doze but I’m too wired from lack of sleep.  It’s a weird dichotomy, I sleep and feel good when I wake, but the moment I stop doing stuff, the utter exhaustion hits for a moment.

1815:  At work and change into scrubs.  Read the census board as I walk past toward the break room.  Notice how all the day shift nurses have that haunted look of exhaustion too.  Not a good sign.

1825:  Sit down with the day charge nurse and get report on all the patients.  Procedures done today, how agitated they’ve been, who’s been unstable, what family we’re going to 86 if they don’t leave and the most important part, what the census is and how many nurses that qualifies me for.  Looks like we’re at 16 (of 22), which calls for 5 including myself, I have one nurse on stand-by and an ED full to capacity.  One patient is on the way from ED and hasn’t arrived, 2 just rolled in at 1800.

1835:  Draw up the assignments for the night, trying to balance admits with heavy patients and how far they have to walk.  It’s not easy and somedays I feel like I’m not even close to being fair.  Tonight is one of those.  I briefly look at my patients.  First is 80 y/o male s/p colonoscopy, history of colon cancer and severe O2 dependent COPD.  The other is a 35 y/o male in with extensive bilateral PEs and a whopping dose of anxiety.  Today he had went to the cafeteria and nearly passed outin the stairwell, had a Code Green called (which usually is for visitors, but hey, whatever) and was getting extensively worked up.

1850:  Grab an extra locator for our resource nurse, make copies, collect the report sheets and head for the break room.  There I divy up the report sheets and make small talk with the nurses as they come it.  We’re out by 1905, which is near record time these days, but I’ve got a good crew tonight.

1910-2045:  See my patients, do vitals, assessments, help the echo tech with a bubble study to see if my PE guy has a PFO (never done that before, it is way cool!).  Update the census board, attempt to chart while fielding phone calls from our staffing office and the nursing supervisor.  The ED still looks packed.

2100:  Bed rounds, where all the charge nurses get together with the nursing supe to determine bed availability.  I come to hear if I’m going to get screwed.  Luckily there are medicien beds in-house, so I’ll only be getting tele patients tonight.  It’s always nice when we’re not the dumping ground.

2115:  Sling meds and tuck my peeps in for the night.  One of the guys on the floor on a lidocaine has flipped into rapid AFib while I was gone, even with a heart rate of 150 he, “feels fine!”  For the next 2 hours I help the nurse give amiodarone, diltiazem, PO metoprolol, but nothing seems to do the trick, only thing that happens is that his pressures start to drift.  I field the normal slew of questions, which doc to call, should I call, would you hold this medication and act a sounding board for my fellow nurses.

2330:  Get hit with 2 admits right in a row.  One’s mine for the moment and in a brief moment of calm, I manage to call the wife to wish her a good night.  Call staffing for my extra nurse, but find out she won’t be here for at least an hour.  Settle my new lady in, do the assessment, medication reconcilliation, admit history, then go to enter orders on her and the other admit, for I am the secretary at night.  Take a moment to pee.  Look over daily charges before I hand them over to the tele tech for entry.

0030:  Relieve  tele tech for his lunch.  Continue charting on all three of my peeps, get 2 new charts set up for 2 new patients waiting for our services in the ED.

0045:  Give report to stand-by nurse and shuffle assignments to make sure she doesn’t get only admits.

0100-0400: 4 more admits roll in.  In between patients and calls to the docs, I get my MARs signed, get my 24-hour chart checks done and finish off my charge nurse paperwork, all while eating my lunch.  Staffing calls for the census at 0400 and for confirmation of the names for the oncoming staff.    Do vitals and assessments again on my peeps.  Sit and chart on them while the tele tech goes and posts the shift’s strips in all the charts.  When I’m done I print out the census sheet that the charges use for report and start getting general report from the nurses.  It can be tedious, but it’s saved my tail a couple of times.  Luckily tonight the other problem children have been self-limited.  A couple of boluses here, maybe a little IV metoprolol,  some Ativan and a little Haldol for the crazies.  Not mention the boosts, the shifts, the help with clean-ups, nor wrangling the little confused gal who had managed to wrap herself up in the IV tubing of her diltiazem drip to the commode and back to bed without losing the site, no mean feat that!

0600:  Call staffing for the name of the extra nurse that we called for.  Find out they’re canceling one of ours, and giving us 2 resource nurses.  See the day charge walk by.

0630:  Give report, mention that we have multiple drips, a couple fo crazies, several discharges, 3 stress tests and a possible angio today.  But hey, we’re full and that means we get to work!

0700:  Act like ahuman Pez dipenser giving out Protonix and Levothyroxine.  Give report to the smae nurses I got report from thankfully.  It goes like this:

Them: “Any changes?”

Me:  “Nope.”

Them:  “OK, have a nice weekend!”

0730:  Outside to the bike cage and starting the ride home.

0820:  Get home, grab a snack, shower, watch a little morning TV.

0900:  Crash.  Thank God it’s Friday!

Writing it out doesn’t seem so bad, but it’s the intangibles that kill you.  The questions, the assists, the coordination with other departments and hospitals.  Not only am I a nurse, I’m a supervisor, an air traffic controller, a spare set of hands, a secretary, answerer of call lights, and a tele tech.  It wears you out.

What Not to Wear

One reason I love my job is that I literally get to work in pajamas.  Scrubs are perhaps the most utilitarian of all work uniforms:  comfortable, relatively inexpensive and easy to wear.  I would know.  Having worked in a variety of industries, I’ve had the pleasure of wearing multiple uniforms.

The worst:  slacks, shirt & tie.  I wore this as a cargo loadmaster for an international airline.  For me, being hands-on is an important part of the job, so I ruined numerous dress shirts, countless pairs of pant and a couple of ties as I squeezed in between cargo pallets and into the nooks and crannies of a modern cargo plane.  I was finally able to convince the powers above that as I was working nights, there was no need to wear said uniform.  Khakis and polo shirts became the new dress code.

Second worst: white shirt, bow tie and black slacks.  Worn as a server.  What really topped it off was the full body apron, very classy, especially when you spill food stuffs on it.

The normal:  working as janitor I wore whatever I had been wearing that day.  No changing to go to work, just show up.  Shorts and t-shirt?  Just fine.  Sandals?  Sure.

When I loaded planes, it was jeans and shirts.  Then when winter arrived it was full-on rain gear and insulated coveralls.  But none of these can hold a candle to scrubs.  They are, in my mind, the perfect uniform.  But they are a double edged sword.  Just as you can look good in them, you can also look like a slob.  Dirty, wrinkled, strange color combos and prints, it can all add up to something less than professional.  And many folks don’t care about how they look, they just show up saying, “I’m here.” looking like they rolled out of bed.  Any wonder why image is a big problem for nursing.

A problem I have is finding scrubs I like.  Not a huge fan of the pastel colored prints, for obvious reasons.  And there is not a plethora of “manly” scrubs out there.  While I do agree that this is a female-centric industry, there are more men arriving every day.  For some of the chaps, the unisex scrubs fit great, others not so well.  While there are plenty of scrubs just for the gals, there ain’t much for us boys.  Now I’m not saying we need crazy prints, but prints could be a nice addition.  For now we have to sort through the rests to find those we like.  I’m not completely happy with what I’ve found, an am always on the lookout for different styles, but they do the job well.  I’m still looking for the penultimate scrub set that makes me totally happy.  The search will continue

One thing that scares me though is the public perception.  Recently in a survey at our hospital, a large (>50%) portion of patients identified not knowing who the RN was as a problem.  We all look the same:  RNs, CNAs, Techs, Phlebotomists, etc., all rock scrubs.  Granted, we do look the same, or at least similar.  In the solution portion, in a throwback to an earlier time, 28% responded that whites would be the best way to identify nurses.  Whites?!  Are you kidding?  I have a hard enough time keeping my colors clean and whites would be a nightmare.  I wore white as a student, it was only a top and only for a year, but it was not pleasant.  Not to mention that whites further the image of the nurse handmaiden.  We’re professionals, no longer the pillow-fluffers of yore.  Not that I’m saying those that came before were not professionals, far from it, but that image, the nurse in white is seen as that stereotype.  When you look up naughty nurses (not that I’ve done this…) I’m told they wear whites, not scrubs.  Perception.  Requiring nurses to wear whites, brings this back.  What’s next? Hats?  Candy stripers?  A more palatable version might be profession specific colors, but that could get old in a big hurry.  There may not be a solution to this that works for everyone, but I know that the solution is not whites.

Men in Nursing

Nurse Sean put up an emotional post related to men in nursing. It’s a sobering look from the other side. Go give him some support, sounds like he needs a”pick-me-up.”

Read: Men in Nursing

I’ve always felt I’ve been lucky in this regard. There were 10 guys (out of 30 people) in my nursing class. My floor has 6 guys on the night shift alone, with more on the day shift. We’re treated like equals on the floor, treated like professionals and trusted with our patients. Sure, I think I push myself to learn more than your average nurse, but that’s just me. I’m a big nerd. My wife describes me as a black hole of “trivial trivia” and never plays Trivial Pursuit or Scene It! with me, unless we’re on the same team. But I digress. I know that there is underlying resentment from some female colleagues about men in nursing, like somehow we’re invading “their” territory”. I know there is a societal aspect to this as well. Men in nursing are either: gay, criminal, sexual predator, or a freak, according to society. I’m none of the above. My colleagues at work are none of the above. Society likes to call me a “murse”. When my friends call me a “murse” I crack a bad joke about their momma’.

We’re professionals. We strive to be the best we can be, in spite of societal and deeply held cultural biases against us. But I think there is hope. It’s becoming more common to see nurses who happen to be male. People are starting to get used to the idea, at least here in the States and accepting us as nurses. Change takes time. Hopefully Sean is willing to give it the time.