High Heeled Nurses

I finally started clinicals yesterday. If there's a negative about this master's program, it's that the clinical coordination is very poor. It's a very patched together affair. Frustrating.

I like my preceptor. She's about eight years older than I am. She's from New Hampshire, and She's named Halene. Just to keep things confusing. she's a trekkie. She even has a picture in an enterprise uniform photshopped into a scene with Data, Warf and Deanna. And she's smart---smart, smart, smart. The view from this perspective is interesting. We rounded with the physicians through the ICU's. The bedside nurses in the other ICU's seem to just evaporate--they fade into the woodwork. They're not acknowledged at all. Rumply and worn. The divide between the tellers and the doers was very clear. It was very strange.

Not a lot of work gets done at the administrative level. No one manages their time well. There's a lot of standing around, leisurely conversations about kids and stuff--I'm not saying she doesn't work, because she obviously does, but the time pressure is obviously not so keenly felt. I feel I have to use every minute in my life, this isn't something people really seem to understand at this level. But there are probably subtleties I'm not picking up on. People dress nicely. They have time for lunch and they wear nice shoes. Halene hasn't lost too much touch with the realities of the bedside, which is refreshing. She realizes for example the danger of our task oriented ethic, and she's good at seeing systems as a whole--the larger forces at work in a situation. I also caught the whiff of a lot of blame resting on bedside nursing (not from her, just from the tenor of the conversations I got to sit in on). And I realized something: everything you do gets noticed by someone.

Hmmmm.....Nursing is a self-hating profession. The ones who rise really never, ever, want to go back to their blue collar roots. It's like having poor, obnoxious, immigrant relatives--you want them as far away as possible. And who wouldn't want to be away from it, once you get the chance to, once you realize that your world doesn't have to be comprised of shit and blood and death and blame? Exhausting 14 hour days with no time to eat or rest. Who wouldn't?

In her quiet office, we met with the multidisciplinary team to plan patient care. One of the patients had just had care withdrawn. All the sudden we heard screaming and wailing, sobbing--an endless, endless cacophony. "What's going on out there?" the physical therapist asked.
"they just withdrew care on Mr. Rawalpindi." Halene said. Rawalpindi had been in a coma for two years. He got pneumonia and had too many complications. Then we heard the sound of retching. We sat in the office with the door closed and listened. The screaming and yelling and sobbing and retching sounds continued. We continued on with the meeting, raising our voices a little over the noise from the waiting room.

We went to another meeting. The noise continued.

"I guess it's not as bad as a Klingon funeral." Halene commented.

That's my 1/2 hour.