I Love Nurses. No, Really.
Having been a patient and the mother of a patient, I have to say I love nurses. They do the crap work with little thanks, are more in tune with patients than doctors often are, and often provide the only human touch you're likely to get when you're stuck in a hospital. Just like anything else, though, there are some real clunkers who lead me to ask, "What the heck are you people thinking?"
No, I'm not talking about that woman who made us miserable night after night by talking endlessly (and always at maximum volume) and bringing buttered popcorn into the ICU, though she will always rank at the top of my list. . . I'm talking about the ones who so often impact my job as an MT. Forget that doctors really have no business dictating at the nursing station (that's a whole 'nuther rant). Why, when they do so, does no one seem to acknowledge there's someone on the phone who might need to be heard? What explains those extended gab sessions that often have nothing to do with patient care?
I just finished a 9-hour shift monopolized almost exclusively by a dictator I'm not fond of, an infectious disease guy who always dictates from the ICU in the middle of the night. It's bad enough he works so hard to dictate everything in his own weird style, trying to sound erudite by using words and phrases no one else does, pronouncing things incomprehensibly (honestly--who pronounces "eczema" as ex-ZY-uh-moh?), and never dictating anything in the same order (so he's impossible to create a standard for), but for the majority of the eight hours I had to put up with him, there was a gaggle of women gossiping and guffawing right there, over his shoulder. It sounded like the lounge at a sorority house on a Friday night, minus the booze. Did they not have critically ill patients to watch over? Seeing as how he dictated on 28 of them--the majority intubated and critical--I wager they did. But noooo, it was more pressing to discuss someone's date, another's shopping trip, dinner plans, boyfriends, and occasionally, apparently amusing patients ("His glucose was WHAT? Hahahahaha--that's ca-RA-zy!") You can tell when the cute doctors come through because the conversations get extremely flirtatious. Well, okay--that can actually be funny to eavesdrop on if it doesn't happen all the time. . . but how do you even have strength to talk this long? I'm not sure if I just never got the average female bonding routine or if I've become less inclined to relate to it after working in solitude all this time. Doesn't nursing wear you out enough on its own without the frenetic, five-hour coffee klatsch in the middle of it? Does no one appreciate the concept of courtesy, or at least realize that they're interfering with someone who's actually trying to do their job? Perhaps even more incomprehensible are the dictators who simply plod along, oblivious to the racket--rarely raising their voices to be heard over the din, though occasionally turning away to interject a comment here and there.
Maybe I've been sensitized to this phenomenon because I just spent a week in a hospital with my son--a hospital that has apparently listened to customer feedback and has made incredible improvements in the atmosphere there. Amazingly, this was the same hospital at which we had our miserable ICU stay with Nurse Boisterous. This time, however, the socializing was very low-key, the patients were all treated as the main focus, and despite a much more businesslike approach, the staff seemed extremely upbeat and personable. Even more incredibly, this was a public hospital, with the county's main trauma center. We did catch one doctor dictating into his armpit, which made me cringe on behalf of the MT who gets to do his transcription, but it was fascinating to see such a generally concerted effort to do things the right way.
Oh, that this had been the case with my own ICU staff last night. We will always have to contend with dictators who subject us to ridiculous things--from poor speech habits to the guys who dictate during the snapping of a lithotripter--but really, must other staff work so hard to compound their shortcomings? I know--no one's ever going to consider the transcriptionist, the lowest on the totem pole even before we were all off-site and out of mind. . . but you might consider all those times you've said doctors take nurses for granted, multiply that by 100, and consider those of us even further down the food chain.
Luckily, the vast majority of my dictators these days are remarkably good and the clunkers are few and far between. If the gods are with me, tonight I'll get a slew of procedure notes, dictated from the sanctity of the private office and out of the main traffic pattern, or some discharge notes by some meticulous RNs who restore my faith in them all.