A Nurse With Attitude

Where Dark Cynical Humor, Nursing Issues, and Politics Seem to Merge

Archive for the month “December, 2012”

Stress in the OR

thCA9ZDP4OThere is a lot of stress involved in working in the OR.  The cost  alone  for operating room time is around forty-two dollars a minute.  With the new Obama health care plan, and the tightening up of federal Medicare and state Medicaid dollars, the nurse is becoming more and more under the gun to “save time”.  It doesn’t matter that the doctor in the room may not be really sure of the specifics of the procedure.  It doesn’t matter if the doctor has never done this particular procedure  in his life… and has to call on a colleague from another department to give guidance (consultation).  It doesn’t matter if there is only one set of instruments and there are three cases to do.  Or maybe the medical student drops that special item in that one and only instrument tray.  It doesn’t matter that the light bulb blows out in the OR lighting, or the only computer  for our “computer documentation” is suddenly locked up.  It doesn’t matter that the patient has thought up another 37 questions to ask before he is ready to roll back to the OR.  It doesn’t matter that the patient forgot to stop his Coumadin prior to coming to the hospital and anesthesia now wants to draw lab work.  It doesn’t matter that the patient came to the OR (from the ward, ICU, ER or where ever)  with twenty seven pieces of “personal jewelry,” slippers, full  clothing, a watch and two wallets full of money and “important papers”.  For all problems, no matter who or when they originated, no matter what equipment failure occurs, the circulating nurse is responsible.  The division director has told me personally  that the nurse is “the gatekeeper.” So as the “captain of the boat” the nurse is the bearer of all responsibility and therefore all blame.

This has been the accepted rule for years and most nurses were perfectly ok with it.  Lately, it seems, management is tightening the belt and wanting to shave every minute from the operating room time to cut cost.  This morning we had an “all staff” meeting to discuss why we are not getting our first cases in by 0730 and why we can’t get our turnover time less than 20 minutes.  Well,  I have one question… Does that girl who cleans your room at Holiday Inn Express take less than 20 minutes to clean your room before you sleep in it?  And if she does clean your room in a brisk 20 minutes, can you do surgery in that very room and not get an infection?

We are not alone.  The surgeons are stereotypically targeted as the top earners in the surgery department.  For that reason, they too are starting to get a heat from the administration, in an effort to save money.   They are quite unhappy at the idea of a bureaucrat with no medical background telling him how the cow eats the grass, when it comes to doing a surgical procedure.  Because of this, they are even more irritated at the “gatekeeper,” or the nurse in the room when things are not going perfectly smooth.  When tempers flare no one wants to be “in the room.”  Especially the administrators,  managers, and the very people who are causing all of the stress.  Everyone, even support people are doing the utmost to steer clear of the difficult procedures.

The other day we were doing a laparoscopic procedure.  That’s when you have a camera and a little scope looking onto someone’s abdomen This procedure is for removing your gallbladder with only a few very small holes instead of one large incision.  Laparoscopic procedures, when everything goes well,  is cost effective and allows for a much shorter recovery time.   Anyhow, the doctor wanted a second monitor screen on the other side of the bed to power up a second camera.  I couldn’t get the screen to work.  I switched the switch, changed the camera, changed the light cord, rebooted the computer, and it still wouldn’t work.  I called the bio-engineer to take a look at it.  After the first ten seconds of not getting a picture, the  doctor became furious.  The tech guy was also reluctant to help because of the heat  radiating from the surgeon in the room.   I insisted and forced the issue with the tech guy.  Once he arrived, he flipped a few switches behind the monitor and the picture magically appeared within about three seconds.    I asked, “hey, how did you do that… I mean, when it happens again, I want to be able to fix it so we may avoid all this  drama and harsh language.  I mean,  why wouldn’t you want to not have people yelling at you if you could avoid it?”

The tech guy said,  “well, it’s quite technical, I don’t’ think that you could…”

I interrupted, “Hey, wait… just let me know,  I mean, I’m pretty technical… I do my own auto repair,… I did machine work for GM back in the 80’s… I mean really, how hard can it be?”

He looked at me a inquisitively  and said, Hmmm, I don’t know…  you might mess something up.”

I was feeling a little put out, “you gotta tell me… you just gotta.”

He smiled, “well, if you must know,  I’ll tell you how to trouble shoot something like this.”

I was pretty jazzed, “great, tell me how you fixed it.”

He smiled again,  and saying in his most condesending voice, “OK,  if you must know… it seems that the switch… you know the ‘on and off switch’ well it seems that this particular switch was in the wrong position for proper operation… it would be wise to check this switch first if this  problem were to ever happen again.”   Then he laughed out loud as I stood there dumbfounded.

Who said tech guys had no sense of humor.


Time to Put away the Christmas Decorations


Sorry guys for not posting in a while.  My middle son got me a few video games for Christmas.  And oh man, how those things really suck your time.  Unbelievable.  I que up one game, and then next thing I know,  it’s been three hours gone!   Oh well, it’s still pretty fun and entertaining.  I’m just making a conscious effort to not play too long.

Elf on the Shelf… Evil ?


Elf 1

Anyone heard of the The Elf on the Shelf tradition?  Apparently, there is a thing that has been going on for a little while where you purchase a little elf from the “elf adoption center.”  The elf is not actually a toy.  It is a stuffed elf when you’re looking at it, but in reality, it is a real elf that is faking as a fake.  Through  observations by these “adopted elves” is the new way Santa will finds out  who exactly is naughty or nice!

Elf 2


Well, the wife got one for sitting on the mantle and “observes” all of the goings on’s in our house and reports it back to the boss at the North Pole.   Well,  I realize that I just may not be on the “good boy” list, so I’m still not going to let a little polar spy  ruin all of my fun.  After all, who said that this guy was all good and everything.  I mean, what if these spy elves were malevolent or evil?  Here’s a few pics of our little elf spy caught in the off hours … while he wasn’t looking.  You be the judge.

End of the World!

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It’s the end… at least according to the Maya Calendar.

I say go ahead and have a toddy on this one!

Finally listening to my Doctor!

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Bacon asparagus



OK, My cardiologist has been harping about my diet.  I promised that I would eat more vegatables.  So here it is…

I’m eathing Asparagus!   Well, to make it palatable, I had to wrap it in bacon.  Here’s a pic of my bacon wrapped asparagus.  This is the way God meant for us to eat vegetables.  I never knew that Asparagus could be so incredibly good!

An Insight to a Tragedy


“I love my son. But he terrifies me.”  When I asked my son’s social worker about my options, he said that the only thing I could do was to get Adam charged with a crime. “If he’s back in the system, they’ll create a paper trail,” he said. “That’s the only way you’re ever going to get anything done. No one will pay attention to you unless you’ve got charges.”

In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.  This could have been prevented if the mothers had support.  This could have been prevented if these boys committing these atrocities could have had treatment.

The liberals will obviously clamor to get restrictive gun laws passes… and in the wake of this horrific school shooting, they will surely succeed. The major media is all about “the need for tighter gun laws” and “restricting assault weapons” and even my more conservative friends at work are saying things like “why should anyone need an assault rifle?”    Well, I’ll say that the flint lock was considered an assault rifle in 1860 and the government clamored to restrict the “assault rifle” even then.  The point is that everyone, everywhere is hyper focusing on the gun and no one is saying anything about the nut job who did the shooting.  The elephant in the room what no one wants to recognize is the state of mental  health in this nation today.  Because of our state and federal representatives,  the mentally ill have been thrust into the general population.  This is O.K. if you have a system in place to  take care of people when they are in need.  Unfortunately, there is none.  Because of the cost, mental health care in this country has been shut down.

When  I went to nursing school there was huge state hospitals with many people getting treatment on an inpatient basis.   Since then, the state hospitals have been all but closed and done away with.  This is because of Hollywood and movies like “One Flew Over the Cuckoo’s Nest,”  where mental health treatment has put into a negative light.  Because of this, and the potiential lawsuit, the lawmakers have closed down the hospitals and released the mentally ill  into the public.  So today, if anyone cannot function in society, they are usually end up being housed within the prison system in lieu of proper treatment.  This in not appropriate or humane… but it is certainly cheaper.  Closing the state hospitals are saving money and having the insane living in a cardboard box in an alley is still tolerable.  Unfortunately,  with cutting mental health bad things happen.  What angers me is when someone snaps, steals a gun (or knife)  and kills a bunch of people,  everyone acts surprised and asks “how could this possibly happen?”

I say it’s time to pay the piper and we should make the representatives bare the burden.  I mean, if the answer was so simple as outlawing guns, then lets to it!  Unfortunately, we only have to look to Chicago IL  to see what we are in store for.  In Illinois,  guns are pretty much, all illegal except for  the police.  At 192 homicides just for the month of November,  Chicago is the murder capital  of the nation.

Yep, things are going to get a lot worse.

Shooter at Oregon Mall

Another tragic shooting.

At least one dead, several wounded.

Deputies reported at least one person had been killed and multiple people were wounded, but could not yet provide an exact number of victims.

Deputies do not believe there were any other shooters.

Witnesses tell Fox 12 they saw a tall slender man in all black wearing a white hockey mask carrying an assault rifle.

The real tragedy is that today, the day after the shooting, before any investigation has even been done, the Oregon Senate already has a bill to present to the House and Governor.  For some strange reason, the lawmakers can’t seem to understand that a “gun free zone” is the most dangerous place you can go.  Because police can take many precious minutes to respond, you are destined to be a well ventilated victim.  Fish in a barrel… doomed to your fate.  That is, unless someone, be it an off duty cop, or a deputy or a trained individual with a firearm can step in and assist.   I can’t trust my life, and the lives of my family to simple fate.  I work to be a  self-reliant person. I take classes and train and I also carry my firearm regularly.

Unfortunately, our political leaders who are clamoring to pass restrictive gun control laws in this state, are being dishonest.  Gun control is never about the guns… it’s all about the control.

Holiday Carols for our Liberal Friends


The Twelve Taxes of Christmas

Go, Tell It on the Fiscal Cliff

Steal, Steal, Steal

All I Want for Christmas is Universal Healthcare

Jingle Bailouts

O Rahm, O Rahm Emanuel

Do You Fear What I Fear?

Away in a Prius

O Come, All Ye Occupiers

I Saw Daddy Kissing Santa Claus

Frosty, the Gender-Neutral Snowperson

Here We Come A-Waffling

Mary Was Punished with a Baby

O Nonsectarian Holiday Tree

Damn Ye Wealthy Gentlemen

Little Drum  Circle Boy

I’m Dreaming of an Ethnically-Diverse Christmas

Grandma Got Run Over by a Death Panel

We Three Czars

Protesting Around the Holiday Tree

There’s No Place Like Mom’s Basement for the Holidays

Tingle Bell Rock (as sung by Chris Matthews)

Quote Of The Week


Found on Moonbattery, the original and the original rewrite are here on Texas CHL.


“Do not blame Obama, blame the people of America who have so enthusiastically acclaimed and adored him and rejoiced in their loss of freedom and danced in his path and given him triumphal processions. Blame the people who hail him when he speaks in the Forum of the new wonderful good society which shall now be America’s, interpreted to mean more money, more ease, more security, and more living fatly at the expense of the industrious.”


The original was from Roman philosopher and statesman Marcus Tullius Cicero (106-43 BC).   Only  I  changed out “Obama for Cesar” and  ”America for  Rome”


…. and  Some things never change.

End of the World

Hey did you know that it is only 12 more days until the Mayan “End of the World?”

When the world ends as the Mayan’s say it will..

I am going to do what most red necks do in serious times…

I am going to hand my beer to my MBWITW and say..

“Here Sweety, hold my beer, I wanna try something!”

No damn clue what it will be. But will be something really good.  Something that I have not done in a long time and well…Once more at least…

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