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Burnout

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I’ve just figured out why “burnout” is such an apt description of what happens to a nurse.

Four weeks ago I had a particularly frustrating patient.  She wanted her drugs and she wanted them now.  The doctor, correctly, refused her.  She came up to the nurses’ station to (once again) beg me for drugs. I refused her.  She started yelling at me and telling me, “If you hate your job, you should just quit.”

I told her, “I love my job. And I’m really good at it.”

And then it hit me like a sledgehammer.  “Oh, my gosh. I hate my job!  When did this happen?”

It was such a sad realization because I used to really love my job. I’d look at the old, dried up nurses and I knew I never wanted to be them.  I told my husband that if I ever hated my job and was that dejected about my profession to make me quit.

And just like that, it happened.  I can’t walk away just yet but  I have my application in to some other positions.    The thing about “burnout” is, once a bulb burns out, it’s done.  There is no going back.

Drug Seeker – Part 2

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Megan was a “drug seeking” patient who sticks out in my memory.  Drug seekers are patients who use the health care system to acquire more medication, usually to feed their addiction to mind and mood altering drugs.  Of the many drug seeking patients I’ve taken care of, Megan sticks out for her sheer audacity.

Complaining of back pain, Megan and her boyfriend came to the hospital immediately after being discharged from a hospital 4 hours away.  She said she works in health care but that she was mistreated at an outside hospital; they would not address her pain.

Megan was admitted to our Hospitalist service.   After assessing her and reviewing her records, the physician could find nothing wrong with her back.  He knew that her long distance travel, request for specific narcotics, experience in the health care industry, and benign assessment all meant one thing: she may be a drug seeker.

He went to our state’s Prescription Drug Monitoring Program database. He pulled her up and saw that she had been prescribed 360 Percocet 2 weeks ago and 30 Vicodin 1 week ago.  Interesting. She told the physician and me that she had never tried Vicidon.  Assuming she had none left, she had burned through 2 months’ worth of narcotics in 3 weeks. Red flag much?  She was sent home with a taper of narcotics to help her wean off the drug. My guess is that after taking the taper drugs at a much higher frequency than recommended, she crossed state lines and went to a neighboring state.  Unfortunately, states maintain separate databases.  For all I know, she may have already been pulling her scam in multiple states.

Drug Seeker – Part 1

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“Drug seeker” is a term referring to patients who use the health care system to obtain drugs, usually narcotics. I’ve had my share of drug seeking patients but two stick out.  The first is Amelia.  Amelia was on huge doses of Oxycontin and came in complaining of abdominal pain.   She was experiencing such bad constipation from the Oxycontin that she was impacted.  She was treating the abdominal pain with more narcotics, which was not helping.  She was so impacted that she had to use her finger to remove stool from her rectum.  Being impacted is not only gross, it’s dangerous.  Amelia could end up with a paralyzed bowel or a bowel perforation.

Despite the impaction, she wanted the doctors to write her a prescription for more Oxycontin.  The doctors, rightly, said that they would only write her a prescription for a taper (i.e. decreasing) dose to help her get off the drugs without going through a painful withdrawal.  Amelia said, “If you don’t give my drugs, I’m just going to go home and smoke a big fat blunt!”  The doctors told her that they wished she wouldn’t but they sent her on her merry way.

Anthrax Scare

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Over the weekend a nurse told me a story about an anthrax scare.  Apparently, the cops showed up to a house where a man was a bit out of it and there was white powder all over the room and the gentleman.  The gentleman claimed he did not know what the powder was or how it got there. Due to the threat of bioterrorism, the police called a biohazard team.  Dressed in biohazard “space suits” the biohazard team brought the man out of the apartment, stripped him naked in the parking lot and hosed him down.  I’m sure it was quite a scene!  It turned out the white powder was cocaine.  When they searched the house they found a kilo of cocaine under the couch.  Apparently the cat had gotten a hold of the cocaine, tore it open, and dragged it all over the apartment!  The gentleman was brought to the emergency room and admitted for his drug intoxication.  What a story!

Humor From the Frontlines of Health Care

A first post to introduce myself.  I’m a nurse interested in public health, health care policy and management, and nursing.  In other words, I’m interested in the front-line, the bottom-line, and bottoms!

Nurses often share stories with one another to compare what’s going on in our world and to share a laugh.

Some fun situations only a nurse would find herself in:

  • Patient in Labor, about to give birth:       “My butt!  My butt is hurting!”
  • Patient’s mother: “Honey, that’s not your butt hurting, that’s you’re baby coming!”
  • Patient  (who is supposedly alert and oriented):”I spilled all my jelly beans all over the floor and can’t get up to pick them up.  Can someone come pick them up for me?”
  • Me: “Sure, I can have someone from environmental services come sweep up.”
  • Patient: “Well those jelly beans are my favorite!  Can you pick them up and hand them to me so I can eat them?”
  • Me: “Absolutely not!”
  • Patient who was definitely alert, but very disoriented: “Look at the TV! I think that’s Latoya Jackson. She must be sad.”
  • Me: “Where? on TV?”
  • Patient, still disoriented but surprisingly aware of MJ’s death: “Yes, right there, that’s Michael Jackson’s sister.”
  • Me: “Sir, you’re confused.  That is a white Animal Planet cop rescuing an alligator.”
  • Me, finishing up diabetic teaching to patient with uncontrolled diabetes: “So let’s review, name a food that is a starch.”
  • Patient: “A pork chop.”
  • Me, deflated.
  • Friend of a nurse: “Hey, I’m going on a long plane flight to Europe.  I think Vicodin will make it easier.  Can you bring me some Vicodin from work?”
  • Nurse: “Are you kidding me? Absolutely not.  Where do you think I work? A meth house?  They’re not giving the stuff away as door prizes!”

Being a nurse is definitely a crazy job.  Sometimes it makes you wonder what life is like for other people, people with normal jobs who get to do all sorts of things during the day like actually sit down to eat lunch, have a bathroom break and maybe, just maybe check your email despite the possible evil eye from management.

But no one else in health care gets to be so close to the family, to understand what is really going on in their world, and to hopefully bridge the gap between medicine and human being.  Despite the jokes, complaints, and other coping mechanisms, being a nurse is truly a beautiful profession for which I am grateful to be a part of.