Monday, April 21, 2008

Acute Dialysis - Day One

It sounds great. Patient nurse ratio 1:1. Bring something to read because you'll be sitting down for four hours.

Four hours? What nursing job lets you sit for four hours straight? Wow. This my dream job. And it pays a whole lot more than any other graduate nurse job I've heard of. Some of the nurses told me that they made six figures last year. Six figures. My first year out of school. Oh man!

I figured sooner or later there would be something about this job that makes is suck bad enough that no one would want to do it. Turns out all the things that are good about it are also the things that make it suck.

Nurse-patient ratio 1:1 means the patient interprets this as meaning you are their personal servant for the day, at their beck and call. "I'm cold. Give me a blanket. Turn off the air conditioner. Give me a drink of water. My oatmeal is too cold. I need another Sweet N Low for my tea." You get the idea.

This also means we have way too much personal time with each other. The following is a sample of the verbal abuse I was treated to by my patient today.

"You aren't taking care of me right. I hope they don't ever let you take care of me again because you are a terrible nurse. You can't do anything right. You aren't very good looking are you? You're pretty fat for a nurse. If I get pneumonia I'm going to sue you. If you don't take me off this machine right now I'm going to call my lawyer. You never listen to anybody. You're just hard-headed and stubborn."

Yeah, yeah, yeah. Here's the phone, you grumpy bastard. Call your lawyer. Bring it!

Luckily I've had about three years' experience dealing with similar bullshit working in a chronic dialysis unit. I found that the best response is act like you're schizophrenic or retarded.

"I'm not good looking on purpose. I get so tired of men asking me out all the time that this works better. Really? I'm fat. Oh, if my weight is interfering with your treatment somehow, let me know what I can do differently so it won't be such a problem for you. If I'm not doing anything right how about if I heat up these pancakes for you? I'm hard-headed. You sound just like my mother. Oh, I can't tell you how many times she has told me that. You know the two of you would have so much fun talking about me. How's that oatmeal? So I was wondering, if you already have pneumonia, how are you going to sue me for giving it to you? I've never heard of this before and I'm wondering how that works."

I finally figured out how to eeeeeeeeeaase my chair back little by little until the dialysis machine was between me and his line of sight. I could still monitor him but he couldn't see me and, well, it's sort of like dealing with a baby. If he can't see you, you don't exist anymore.

Pretty soon his wife came in. A lovely woman, very attractive, every hair in place, dressed beautifully and very attentive to him. And he was a complete bastard to her. She didn't speak English and so he felt free to say ugly things about her to me.

I forgot. People suck.

Then there is the "nurses eat their own" thing. Yep. It's true. Since it was my first day on this unit I had to figure out where things were, how to make unruly equipment do what it is supposed to do, you know, just figuring stuff out. Every time I came out of the room to ask a question, I was met with much eye rolling. Once I stepped out of the room and two nurses were at the nurses' station and I asked a question. Both of them ignored me. I know they heard me. I'm loud. My mother would tell you. Finally a tech walked by and asked if I needed anything. I said "Oh thank God. For a minute there I thought I was invisible since nobody seems to notice me."

Probably not the smartest thing to say, but I'm only working near them, not with them. I could see the nurses huddling up, talking about that "stupid dialysis nurse". Wow. Eighth grade all over again, only without acne and I can smoke in front of anybody I want. And I have a driver's license. And a paycheck. Neat.

But I took the high road. When I left the unit I gave the nurse report on my patient and was all professional and business like. I thanked her for everything and said "I look forward to seeing you next week. I really enjoyed my day." If she thinks I'm crazy maybe she won't poke a stick into my cage.

The other thing that could be a negative is the ominous rumbling of many long hours. Yeah the nurses earn six figures but they earn every single penny. I'm hoping that somehow I can balance those long hours doing things I would usually do with my down time - reading, crossword puzzles, surfing the net on my Blackberry. But I get the feeling that somehow it's not quite going to work out like that.

At any rate, I can't think of any other nursing job that would work for me at this stage in my life. I won't be running up and down the hall, patient to patient, juggling hundreds of life and death details. The next patient who asks me why I'm so incompetent and stupid I'll just say "would you like some fries with that?"


Anonymous said...

I love your blogs! I am fixing to graduate Nursing school in a week, an Associates Degree 2 year program. My first job is at a chronic dialysis unit. I am soooo nervous!!! Ill keep your blog link and be reading up! Oh, yea the whole thing with the men, that kinda scares me a bit, but it doesn't surprise me at all!

License Pending said...


It's my goal to be entertaining and informative. I'm glad to know it's working.

Congratulations on graduating and your new job. Keep coming back and feel free to e-mail me if you have questions.

Chronic dialysis has a long learning day. You will go home feeling like a failure for months. Please don't give up!!! Everyone has that experience and no one expects you to learn it quickly. They would rather you take your time and be safe. So every time you sit in your car and cry at the end of the day, keep in mind that if you just keep going back and learning, you could move on to a job doing acutes and you will like it so much better.

As for the men, you'll get a thick skin after a while. Your therapeutic communication skills will serve you well.

All the best!! Seriously.

License Pending said...

Um, that's long learning CURVE, not learning DAY.

Sorry. My brains are mush.

Anonymous said...

Hey, can i use your picture you have posted for my website. I think it really depicts how girls gossip.

Let me know! :)


paradiso said...

Hi, In my last comment I had asked if i could use the picture that you posted of the 3 girls talking amongst each other. I wanted to put it up on my site in the section for "fashion gossip". I never left my email...LOL.

If not its okay, just thought i'd ask.