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Dr and Doll

I love Norman Rockwell imagery. There’s something about it that not only speaks of a different time, but a different relationship between the healthcare provider and the patient. He understandably focused on the Dr and not the nurse. In fact, I Googled and found no images of a nurse caring for a patient. That’s not to say he didn’t do any, just that I didn’t find any with that search.

Dr and Doll 2

Regardless of his possible omission, the role of the nurse is very different than it was in the 40’s and 50’s when he was painting these popular images. As I’ve stated in the past, nurses are not doctors, and shouldn’t be.

Doctor and boy looking at thermometer

Something else has been sticking in my craw recently, and that’s the “rights” of patients to dictate their care. As a new RN I’m still navigating the waters in this area. I’m a firm believer that patients should be involved in their healthcare. They have every right to decide the course of their treatment. But managing that on a practical level can be challenging. People continue to eat too much, too often, and the bad stuff. They smoke. They don’t exercise. And I’m just talking about the nurses I know at this point.


Seriously, if a patient continues to behave in an unhealthy manner despite all evidence and advice to the contrary, when is it okay to stop treating? People with psychological conditions are forcibly treated, making it lawful to step in because the patient cannot distinguish reality, or is unable to care for themselves. The current popularity of blaming everyone else for our own condition is valid in a court of law (“They made the hot coffee too hot and I was burned”, “I can’t stop eating McFood, they must put something in it”, “I never would be this fat if they didn’t make Twinkies”….). Isn’t this a similar type of crazy living in a fantasy world?

Shouldn’t the healthcare providers be able to say “no” to the people unwilling to care for themselves in any meaningful way? Part of me thinks hell yeah! this is a possibility, and the other thinks that first part is sick. As nurses we’re here’s to help. But where is the line? Isn’t enabling exactly what we’re doing at some point?

And how about the professional patients? “No, I can’t tolerate dilauded, I need morphine.” “I’m more comfortable on 5 liters of oxygen, not 2.” “At home, I always crush that pill.”

These are the ones that are typically “frequent flyers” in the ED, the ICU, the substance abuse clinics. I spoke with one patient waiting for another set of lungs because her last pair were giving out. She was going through nicotine withdrawals because we couldn’t let her smoke inside. When do we cut them off? If they know so much about how to manage their health, then why do they keep showing up at the hospital?

Now, I’m not talking about the people who despite their best efforts simply cannot control the course of their condition/disease (cancer, AIDS, etc), but those who choose consciously or not to let go of that control until they get into a hospital. I don’t know the answers, but I’m very curious to hear other opinions.


The horizon

I’ve been quiet for a bit (yet again).

I graduated in December. I finished the necessary hours for my CNL certification in early January. I sat for the CNL test in mid-January. I studied for a couple of weeks and took the NCLEX in early February. I started working a few days later. My daughter officially became a teenager a few days ago.

Feels like I finally got a chance to actually breathe with the next few days off.

To begin, I’m soooooo glad to be done with school. I don’t have all the other stuff looming that was constantly in the back of my mind. Work has been going great. My preceptor is absolutely awesome. She’s supportive and available for questions or assistance without constantly hovering over my shoulder. I couldn’t be happier with the match. I had an enormous advantage over other new grads in that I’ve worked there for close to 2 years and actually was able to pick my preceptor. It would be nightmarish to be manacled to someone I didn’t know and discovered I couldn’t work with comfortably.

The CNL certification was a bit of a denouement, as here on the Left Coast the CNL hasn’t caught on yet. This doesn’t mean I won’t be able to benefit from the education, just that I can’t actually use the certification yet. No letters after my name on my badge, as I’m not practicing within the scope of that title. I don’t mind at this point, since I’d rather lay low and learn instead of trying to flash a bunch of creds after my name when I’m still getting my feet under me. I’ve been told that I’m progressing very quickly, and they’re happy with the decision to bring me on as an RN. That is very cool, as I’m enjoying the work very much.

I’ve been catching up on a lot of blogs since I basically stopped reading or writing much of anything aside from study material for a while there. I’ve noticed a distressing amount of ill will towards patients from those in the critical care field. I don’t know if I just was used to it before, or this is a relatively recent phenomenon. I know there are always the burnt out nurses harping on how lousy their lot is, but the flavor of this seems somehow different. Bloggers I liked and read have become pretty negative. In response, I’ve simply unsubscribed and stopped visiting. I’ll need to make sure my attitude doesn’t follow that path. Great power there is in the dark side, but strong I must be.

I’m not sure what my daughter’s birthday has to do with all this, but it seemed like a milestone. Maybe I’m just exhausted from all the change?

I’m not making fun. As it says in the song itself, I wish the people trying to die could be allowed to do so with some grace and dignity.

Stop by Respiratory Therapy 101 for a great blog as well as this song.

Guitar Hero logo

I’ve been reviewing and reviewing and reviewing for the NCLEX. I finally took it. Now I’m wadding and unwadding my panties waiting for the results.

Then I see this video, and I realize I’ve spent my life in vain. Oh, I’ve tried to play the guitar. I’ve mastered about 10 chords. And when I say “mastered” I mean I can play them but not really move between them very quickly. And I know exactly three (that’s “3”, not “300”) strum patterns.

But even those astonishing skills pale in comparison to this guy. I really really wish I could play like that. Just amazing.

People are stupid are amazing have too damn much time on their hands.

Check out the new Ginsus.


I just worked two days in a row as a Nursing Assistant. These happen to be the last days I’ll work as an NA, because I start as an RN in a week.

Yesterday’s shift was different because I “floated” to a new unit, and had to deal with all the nonsense that entails. Overall it went well, however.

Today I had my first body-prep for a patient that had passed away a couple of hours before I arrived. I thought it oddly symbolic that it would happen on my last day, having never done it before. The nurse who helped me with it was very kind, letting me do some of the things and explaining procedures as they’d be done on a “normal” patient versus the current one. It went smoothly and I was glad the patient’s body was treated with dignity the whole time.

Now I’m winding down and getting ready to get some sleep. NCLEX in a few days, and new job a few after that.