sweepthefloor
see jane nurse
- Joined
- May 25, 2010
- Posts
- 11,836
I will take the “mean” doctor any day, over the doctor that smiles in my face, kisses my ass, and fucks everything up.
While thinking about how romantic relationships develop into secure happiness, I have taken the relationship I know very well, the doctor/nurse relationship to figure it all out.
I just swoon for the doctor that can stop me in the middle of my worrisome rambling. After being exposed to weak doctors early on, I tended to treat them all the same. Thinking in my mind, if I do not tell him/her what the patient needs, the patient will not get it. This is called nurse doctoring, and it is very common.
My first experience with a strong doctor, turned out to be my favorite cardiologist. A patient was sick, I was filled with dread, and my mind was spinning as I tried to put all the pieces together. I called him on the phone, spilling and I mean verbally spilling: the labs, the medications, the clinical assessment, and the past medical history…. He listened for a while and then cut me off in mid-sentence, he said…”Janey, that is your name right?” I said, “Yes.” I am thinking, what the fuck, is that all he has to say about this situation, my name? I am thinking what does my name have to do with any of this? I am in a frenzied panic state.
He shows up quickly, the patient’s lungs are filled with fluid, he listens and hears all the rales, the patient can hardly breathe and the blood pressure is 70. At this time, he requests me to push a diuretic of Lasix 100mg into the patient. My hands were shaking, I was afraid, knowing with pressure that low, the dose could tank the pressure even lower. I start to open my mouth to object. He stops me and says, “I know what I am doing, I know what you are thinking, if you don’t push it now, give it to me and I will.” (Oh, I pushed the drug in) The patient got better, and I developed a huge trust and respect for him. I did not have to say anything, I did not have to feel fear, I only had to do what he wanted, and it just worked. When the patient came to his mind later on, he said to me, “You saved me, I could not breathe.” And there is the outcome, under the direction of this awesome, man doctor. There was no wishy-washy, no call someone else, no what do you think Nurse Janey?
Many nurses, talk bad about him, he has a reputation for “being mean.” I defend him behind his back, although I know I really do not have to, he is that good, and if they do not see it, well that is really their loss. They don’t like his attitude, and they don’t like to feel that they are not in complete control. I heard all the stories about him, some straight from his own mouth. In fact, I have seen him flip out. He never is mean to me, and everyone notices it. I even get the requests, my patient needs such and such, and will you call him for me and ask for it? I say no, he will be here, and he will provide what is needed when he gets here, sorry. And he does his job and then more, I see it, I appreciate it. I only have to call him for a change in situation, and when I do, he responds with “So, you want to play games this week or something?” It is not unknown to me, to see him come at the near shift end and walk the hall and see me in a room, doing my job, just checking that everything is fine. I don’t have to come out of the room and talk to him, I just have to acknowledge him with my face and he knows everything is OK, and he leaves without talking.
The examples are many; I suppose the best was when one of his patients was in a code blue. We were doing our job, with advanced cardiac life support, chest compressions, one shock already delivered, he walks right in and takes over the whole scene with a strong presence, that seemed to energize everyone. We all knew what to do, but it just felt better under his control, that went above the protocol guidelines, which I will not bore anyone with here. The piece of paper that is the protocol says this, but he changed it to fit the situation and the patient actually lived. He took a risk, he was brave and he trusted himself, and we all followed, and the outcome was good. I will never forget, him practically breaking into the room in the middle of the code, commanding, “Full charge now, light that bed up like a Christmas tree.” The whine of the defibrillator charging, all clear, and the jolt of the patient rising off the bed, the deadly ventricular fibrillation broken into a normal rhythm, and yes there is a pulse! (Full charge is 360 joules). It did not end there the patient went in and out of a deadly rhythm, but he never stopped ordering medications to dump and many shocks delivered till the patient sustained a pulse, and rhythm.
He is not the only strong, trustworthy doctor, there are many of them, but they do seem to be in the minority. I just chose him as an example because I like him very much. I got the words from him as a new nurse, “You don’t know me yet, but you will find out.” And surely I did find out! It is a pleasure nursing his patients. He tells the truth, even when it hurts.
It goes along the lines of this is what we are going to do, as opposed to the weak doctor who says, “What do you want to do?” I don’t mind having my opinion or my knowledge base tested, but I surely do not want that much responsibility all the time, after all I have so much work to do. I know I am smart; I don’t want to have to prove it all the time.
The opposite of him, is needy, the insecure doctor. I spend my shift, worrying. I get the “Why didn’t you call me about these labs?” or “Why didn’t you call me sooner?” or “What does the patient need?” or “Janey, come with me to see this patient, please, please” I am thinking well, I want you to do your job! They pawn everything off on everyone else, consulting every specialist under the sun and ordering every test known to acute care. This turns me into the worried nurse, I don’t trust them, and I know that I have to work harder. I know then that even though the doctor has assessed the patient, something is missed, and I will have to make another phone call. I know that even though the research shows this, they will order that. I know I will have to call and tell them that, and then the orders will be changed to what I recommend. (Much of that has been actually taught to me by Fave Cardio types, I see what they do, and it works, I am a highly trained monkey) The circle goes round and round, the patients spend longer times in the hospital, develop secondary problems related to hospitalization, and the outcomes are poor in compared with the care given under the other personality mentioned above.
Now, if I had the time, I suppose I could do a research project, on personality and outcomes of patients. Surely these weaker type doctors have the knowledge base to provide adequate care, they have the ability and the mind, but the personality driven by insecurity and fear maybe, defensive medicine as we call it changes the outcome. The stronger type doctors, get to the point, they assess and trust themselves, they treat and they discharge. The weaker type digs a hole, deeper and deeper, finding things that were not even a part of the admission diagnosis, they treat for that and find more problems, many of which could be treated as an outpatient, but that topic will lead to an essay on wasting resources, insurance companies and hospitals going bankrupt, so I will stop.
I am not trying to degrade the weak doctor; after all it appears to not be their fault completely. The system is set up to spoon feed them, and they are used to it, and depend on it. I am also not saying that the strong natured doctor never makes mistakes.
How does this all relate to love relationships? After realizing what provides happiness and security in my professional relationships, I gather the same will hold true for the intimate love type. The word love, by the way is a four letter loose word that I am not fond of, I use it here for lack of a better word. I am not anti-love, I just relate better to biology. I am secure with my self; I don’t need to be involved with a weak man that I can control or manipulate to “feel better about myself.” In fact, I desire a strong hand that leads to trust, respect, accountability and the best freedom from worry. It works in the hospital; it might work in life too.
So, the mean doctor is not so mean after all, he smiles at my face, when I am not looking (everyone else sees it), and nothing is fucked up. When your life is on the line, you will want the mean doctor too, and the nurse that follows his lead.
You think he is a brute? You think I am a dumb nurse? I see the outcomes, my mind is set in the right direction.
While thinking about how romantic relationships develop into secure happiness, I have taken the relationship I know very well, the doctor/nurse relationship to figure it all out.
I just swoon for the doctor that can stop me in the middle of my worrisome rambling. After being exposed to weak doctors early on, I tended to treat them all the same. Thinking in my mind, if I do not tell him/her what the patient needs, the patient will not get it. This is called nurse doctoring, and it is very common.
My first experience with a strong doctor, turned out to be my favorite cardiologist. A patient was sick, I was filled with dread, and my mind was spinning as I tried to put all the pieces together. I called him on the phone, spilling and I mean verbally spilling: the labs, the medications, the clinical assessment, and the past medical history…. He listened for a while and then cut me off in mid-sentence, he said…”Janey, that is your name right?” I said, “Yes.” I am thinking, what the fuck, is that all he has to say about this situation, my name? I am thinking what does my name have to do with any of this? I am in a frenzied panic state.
He shows up quickly, the patient’s lungs are filled with fluid, he listens and hears all the rales, the patient can hardly breathe and the blood pressure is 70. At this time, he requests me to push a diuretic of Lasix 100mg into the patient. My hands were shaking, I was afraid, knowing with pressure that low, the dose could tank the pressure even lower. I start to open my mouth to object. He stops me and says, “I know what I am doing, I know what you are thinking, if you don’t push it now, give it to me and I will.” (Oh, I pushed the drug in) The patient got better, and I developed a huge trust and respect for him. I did not have to say anything, I did not have to feel fear, I only had to do what he wanted, and it just worked. When the patient came to his mind later on, he said to me, “You saved me, I could not breathe.” And there is the outcome, under the direction of this awesome, man doctor. There was no wishy-washy, no call someone else, no what do you think Nurse Janey?
Many nurses, talk bad about him, he has a reputation for “being mean.” I defend him behind his back, although I know I really do not have to, he is that good, and if they do not see it, well that is really their loss. They don’t like his attitude, and they don’t like to feel that they are not in complete control. I heard all the stories about him, some straight from his own mouth. In fact, I have seen him flip out. He never is mean to me, and everyone notices it. I even get the requests, my patient needs such and such, and will you call him for me and ask for it? I say no, he will be here, and he will provide what is needed when he gets here, sorry. And he does his job and then more, I see it, I appreciate it. I only have to call him for a change in situation, and when I do, he responds with “So, you want to play games this week or something?” It is not unknown to me, to see him come at the near shift end and walk the hall and see me in a room, doing my job, just checking that everything is fine. I don’t have to come out of the room and talk to him, I just have to acknowledge him with my face and he knows everything is OK, and he leaves without talking.
The examples are many; I suppose the best was when one of his patients was in a code blue. We were doing our job, with advanced cardiac life support, chest compressions, one shock already delivered, he walks right in and takes over the whole scene with a strong presence, that seemed to energize everyone. We all knew what to do, but it just felt better under his control, that went above the protocol guidelines, which I will not bore anyone with here. The piece of paper that is the protocol says this, but he changed it to fit the situation and the patient actually lived. He took a risk, he was brave and he trusted himself, and we all followed, and the outcome was good. I will never forget, him practically breaking into the room in the middle of the code, commanding, “Full charge now, light that bed up like a Christmas tree.” The whine of the defibrillator charging, all clear, and the jolt of the patient rising off the bed, the deadly ventricular fibrillation broken into a normal rhythm, and yes there is a pulse! (Full charge is 360 joules). It did not end there the patient went in and out of a deadly rhythm, but he never stopped ordering medications to dump and many shocks delivered till the patient sustained a pulse, and rhythm.
He is not the only strong, trustworthy doctor, there are many of them, but they do seem to be in the minority. I just chose him as an example because I like him very much. I got the words from him as a new nurse, “You don’t know me yet, but you will find out.” And surely I did find out! It is a pleasure nursing his patients. He tells the truth, even when it hurts.
It goes along the lines of this is what we are going to do, as opposed to the weak doctor who says, “What do you want to do?” I don’t mind having my opinion or my knowledge base tested, but I surely do not want that much responsibility all the time, after all I have so much work to do. I know I am smart; I don’t want to have to prove it all the time.
The opposite of him, is needy, the insecure doctor. I spend my shift, worrying. I get the “Why didn’t you call me about these labs?” or “Why didn’t you call me sooner?” or “What does the patient need?” or “Janey, come with me to see this patient, please, please” I am thinking well, I want you to do your job! They pawn everything off on everyone else, consulting every specialist under the sun and ordering every test known to acute care. This turns me into the worried nurse, I don’t trust them, and I know that I have to work harder. I know then that even though the doctor has assessed the patient, something is missed, and I will have to make another phone call. I know that even though the research shows this, they will order that. I know I will have to call and tell them that, and then the orders will be changed to what I recommend. (Much of that has been actually taught to me by Fave Cardio types, I see what they do, and it works, I am a highly trained monkey) The circle goes round and round, the patients spend longer times in the hospital, develop secondary problems related to hospitalization, and the outcomes are poor in compared with the care given under the other personality mentioned above.
Now, if I had the time, I suppose I could do a research project, on personality and outcomes of patients. Surely these weaker type doctors have the knowledge base to provide adequate care, they have the ability and the mind, but the personality driven by insecurity and fear maybe, defensive medicine as we call it changes the outcome. The stronger type doctors, get to the point, they assess and trust themselves, they treat and they discharge. The weaker type digs a hole, deeper and deeper, finding things that were not even a part of the admission diagnosis, they treat for that and find more problems, many of which could be treated as an outpatient, but that topic will lead to an essay on wasting resources, insurance companies and hospitals going bankrupt, so I will stop.
I am not trying to degrade the weak doctor; after all it appears to not be their fault completely. The system is set up to spoon feed them, and they are used to it, and depend on it. I am also not saying that the strong natured doctor never makes mistakes.
How does this all relate to love relationships? After realizing what provides happiness and security in my professional relationships, I gather the same will hold true for the intimate love type. The word love, by the way is a four letter loose word that I am not fond of, I use it here for lack of a better word. I am not anti-love, I just relate better to biology. I am secure with my self; I don’t need to be involved with a weak man that I can control or manipulate to “feel better about myself.” In fact, I desire a strong hand that leads to trust, respect, accountability and the best freedom from worry. It works in the hospital; it might work in life too.
So, the mean doctor is not so mean after all, he smiles at my face, when I am not looking (everyone else sees it), and nothing is fucked up. When your life is on the line, you will want the mean doctor too, and the nurse that follows his lead.
You think he is a brute? You think I am a dumb nurse? I see the outcomes, my mind is set in the right direction.
Last edited:
