Pee and Sympathy: True Stories from an RN

Scrubs

2010-09-19T18:59:00.003-04:00

5 things I hate about you:

The ninja nurse. This is the nurse who disappears quicker than Endora on Bewitched. She vanishes without a trace then appears with peanuts and a Coke. By that time there are numerous requests by her patients that usually include the word “Bedpan.”

The head nurse MD. The doctor who has nothing better to do than check on the nursing staff. He or she spies on the RN, vanishes and poof. Your Nursing Manager pulls you to the side to inform you of the complaint. All this when charts pile up looking like piano keys and patients are lining up in the hallway complaining of pain wondering where the doctor is.

The hand washing police. You know the one, usually an old maid hiding in the corner with a clipboard.

The no-call/no-show nurse's aide. Have you ever noticed their union is stronger than that of the Registered Nurses?

The Hearing Voices MD. This is the doctor who follows you down the corridor with her list of demands and all you can think is “I’m hearing voices. Hearing voices.”

5 things I love about you:

Patients who take the time to say, “Thank you.”

The ninety-six year-old man who enters triage and says “Please take care of my lady.” She’s 92, short of breath with a walker and they came by subway.

The co-worker who becomes a lifelong friend and can read your mind.

The longevity of a nursing career that puts food on the table and helps with the beach chair on the white sands of beautiful Waimanalo Beach. I am grateful.

The Nurse Manager who puts on a pair of scrubs, places his or her hand on your shoulder and says, "What’s next?"

My scrubs are old and worn out and they represent who I am. I’ve been wearing scrubs for three decades. They can be seen in the dark on an early Sunday morning watching Mimi the Stray cat shuffle by, or late at night after a long shift stretching my sore knees waiting for the crosstown bus. My stethoscope is a lei and there are pen marks above the pocket. Friends, young and old, take tape to swipe off the cat hair as I stand ready to face another day. The cell phone heavy in my side pocket, ringing while I push a stretcher, “How's work?” Some days are good and then there are the struggles that challenge what I know. Sometimes I know it all and sometimes I know nothing but there is one certain truth:

When I wear my scrubs I am not on the passenger’s side.

(A big thank you to Scrubs Magazine for publishing a few of my stories.)

Taking a Little Break

2010-08-15T14:30:00.002-04:00

Hi everyone,

Working extra shifts has left me little time to write new posts. As soon as I have my work/life balance back to normal, I'll be back to writing.

Thank you for your messages of support!

NYCRN

Cooler Than Me

2010-07-19T21:29:00.001-04:00

It’s hot as hell in NYC, but sometimes the heat has nothing to do with the act of cooling off.

Kiki-Dee, our social worker likes to stick her head in the cool trade winds of the air conditioner, and I love it. The first time she did this I was telling her about a Grey Goose martini and she became extremely clammy. I said, “Kiki-Dee are you alright?” Right then her wig started flying in all directions as she placed her face in the cold humming box.

“Kiki-Dee, won’t that wig fly right off your head?” I said with the concern of a weave master. “No child, it’s sewn in,” she explained.

I knew then and there that she was living sober. The mention of a chilled martini was bone-chilling talk and I liked this woman too much to mention a Bacardi and Coke. (I admit, I was dying to see her cool off again). The mere mention of a cocktail was a twist in her sobriety.

Kiki-Dee got her degree at NYU and her cubicle is placed in the back of the ER right next to the patient’s bathroom. Once I had to clean a trail of diarrhea next to her open-toe sandals and she thanked me for it. I was on my hands and knees and she said, “On your knees again?”

I answered politely, “It’s not the first time honey and be quiet before I tell you about Miller Light.”

I think of Kiki-Dee when I lose compassion and she mops up after me.

A young lady of 23 was brought to my area with vaginal bleeding, a common problem in the ER. Many females register with menstrual cramps and are sent home with Motrin. For this patient, I drew blood and then banded her with a type and screen since she was pregnant. I did my work in silence and she offered no conversation. She was sent to labor and delivery in a wheelchair and I continued with my work. It was many hours before I saw her again and I placed her behind curtain one where we persisted with our relationship in absolute stillness.

I was too busy to read her chart but I checked for orders and I went back to hang a liter of NS. I was shocked to find her crying. “What happened?” I asked like a complete idiot.

“I lost my baby,” she managed to say with hurt in every heartbeat.

It was the first time I had seen a woman cry over the loss of a fetus. I'm not sure why. Perhaps the sadness occurs before the return to the ER or it happens later at home. In any case I was not prepared for this kind of heartbreak. It felt like a knife in my windpipe. I stood motionless and angry at what ER nursing has taken from me. On some days, I am robbed of my compassion. For all the pain seekers, simple gastritis, return detox, and cold symptoms there comes an emergency that deserves graciousness.

I stood in the heat with a cold heart. The corrosion has taken its toll but I still needed to help this woman. For all it’s worth, I was still a nurse.

I knew where to find kindness and it was wearing a wig by the restroom. Kiki-Dee offered no complaint and followed me to the patient. I pulled up a chair for her and she sat with the young lady for about an hour.

When I asked Kiki-Dee what they talked about she said, “Nothing. Not a damn thing." I realized mere words couldn't change her reality.

"She stopped crying and she even gave a simple smile when I discharged her. You must have done something,” I said knowingly.

“I was present.”

K-D knew as well as I that sometimes we cannot comprehend the feelings of a patient if we have not experienced the same level of personal tragedy. In one moment, an unexpected milestone can happen to a patient and it is a nurse who will bear witness. “Sometimes presence is all it takes.”

Then Kiki-Dee did something to make me smile again...she stuck her head in the air conditioner. When I noticed the infinite colors of eye shadow traveling into her forehead, I laughed and said, “Be careful girl, that rushing air will blow your eyebrows off.”

Like a pro, she said, “No it won’t, I forgot to draw them on.”

And as I watched her bob her head in the brisk breeze of electronic winter, Miss Kiki-Dee took a long, cool sip from a tall bottle of water.

N.U.R.S.E. - Insert Your Own Adjectives

2010-07-03T09:04:00.007-04:00

For all nurses on Independence Day.
Just a reminder of how truly important and needed our profession really is.

(A reader sent me this video starring their adorable cat. Thanks, ER!)

Cake Walk

2010-06-27T15:39:00.005-04:00

I was called a “fag” at my RN graduation by a woman wearing a church hat.

In fact, the graduation was held in a church in Harlem near Malcolm X Boulevard. I was up on stage giving a speech about a nursing career that spanned three decades. I was an LPN for 30 years on the day that I received my diploma for registered nursing and had graduated at the top of my class. It was an emotional journey and my words proved an inspiration because people actually stood on their feet with applause.

I will never be sure why I was called a fag on that special day. What I do know is that I had every right to be there because I worked hard for it. My sexuality doesn’t pass medications any more than it could start IVs, insert NG tubes, or change incontinent diapers. My focus as a nurse is on humanity. I am not inferior or damaged because I am gay.

After years of call bells, side rails, medicine cups, and bedside commodes, the textbooks hung a port of call on my back and the baggage was worth the weight. I felt no disgrace with the outdated slur that a friend overheard; the hand-clapping had drowned that woman out.

Who knows why a person would say such an oppressive slang, perhaps it was a whimper of fear towards my culture? Maybe it was just outrage that a man from the Pacific Islands would win the top awards at a primarily black college. Worse, it could have been an aggressive attack filled with hate. All this under a Sunday hat and rows of praying pews. Oh, the irony of homophobia.

I took the state boards equally with Blacks, Asians, Whites, Indians, male or female. I passed the test and became an RN. It was one of my greatest accomplishments; that and winning a cakewalk when I was five (it was a big deal then, cakes were round and homemade).

When I first moved to NYC, I had never seen burkas. I heard a loud knock on the triage door and answered it to find a woman swathed in black from head to toe. My heart pounded because I could only see her eyes. I was scared to death. I looked around for a female nurse but it was lunchtime and I was alone. She sat down and said she had a rash. I could only imagine where the itchiness lay and I didn’t dare pursue the matter. I took her blood pressure over her clothes and wrote “for female MD” on her chart. Since then, I have seen men with little curly pony tails lying over their ears with big black hats and I know they are human and as equal to me as the immigrant who stowed on top of a train to get here.

Other things scare me, such as wigs that change hairlines and Christmas Madamba, an RN doing a “booty pop” in the nurses’ station (now that is just frightening, but the girl is a young nurse filled with the culture of optimism).

Gay is just a culture and the medical world is full of people like me. We form part of the diverse fabric of the hospital atmosphere, a place where patients breathe a sigh of relief or perhaps their last breath…and nurses are there wiping away the blood and the tears. There is a lot of pee and sympathy in what we do.

Happy Gay Pride Day to my brothers and sisters who have survived Stonewall and pray for equality. Life has not been a cake walk. Change is coming.

My Father's ReflectioN

2010-06-19T07:00:00.003-04:00

(I'm re-posting this story in honor of a man who inadvertently made me a better nurse.)

My father once loved a prostitute who wouldn't marry him. Instead, that red-headed "taxi dancer" said "Marry my daughter," so he did. And that's how my parents met.

My mother was 15 and my father a 22-year-old boxer in the Marines. What was to follow was La Vida Loca personified.

Many nurses walk around with an idea of quality health care without paying much attention to the reality of it. That is, until the person needing the care is their sister, brother, favorite uncle or, in my case, a father; a father who in his retirement spent a lot of time drinking Budweiser under a mango tree (in the can...never the bottle!).

Under the life of that giving tree was where my father reflected on his own life:
- He thought about his 8 children, and his baby girl who died while he was in Vietnam.
- He thought about the mother of those children, his crazy wife, whom he loved heart and soul, and how she left him while pregnant with another man's child.
- He pondered about his eldest son, a gay male nurse. "If only his mother had cooked more vegetables," he told his friends at the Veteran's Center.

My father spent so much time on the nails of nostalgia that he ignored the nail under that mango tree. The one he stepped on.

Life continued this way until he ended up in a hospital bed with a black foot and freshly amputated toes. He was a diabetic as well as a drinker.

I flew home to Hawaii to find him in full-blown withdrawal, in a hospital room on the 7th floor.

"She's at the window," he said, his hands displaying all the tremors of an alcoholic.

"Who's at the window?" I asked.

"Your mother," he answered pointing towards the mountains. "She's standing on the ledge wearing her pink nightgown. She wants me back."

"Dad, mom is dead. Besides she could never fit on that tiny ledge, she weighed 250 pounds."

Then I heard the sound of shells. No, not the pearly shells from the Pacific, but the shells from a chicken. My stepmother was sitting in the corner of the hospital room eating hard boiled eggs and rice balls. She was Filipina and never tired of saving money.

"Auntie Rose, didn't you smell my father's rotten foot when you were at home?"

She looked at me annoyed and said, "Of course I did! I thought it was a dead rat."

Just then the surgeon entered the room placing a consent form in my hand for a partial foot amputation. "The infection is getting worse," he explained. "This might slow it down."

"You just cut off his toes, now you want half the foot?" I cried with disbelief.

The surgeon was a about to write me off when I told him I was a Registered Nurse and would not tolerate the "Chop-Chop."

"This is a leg, not a rack of lamb," I shot back. Then I boldly said that I wanted him to perform a below-the-knee amputation. "Cut off the leg," I said. "It's what is going to happen anyway. There will be no chop-chop with my father. He's strong enough to use a prosthesis when he's well."

The surgeon gave a concerned look and said, "What is that smell?" After eating half a dozen boiled eggs, Auntie Rose had started to fart, quickly dispatching the surgeon.

The day after his surgery my father was hysterically blaming his primary nurse for his missing leg. As soon as she walked out of the room he yelled, "That fat nurse cut my leg off! Don't let her near me again!" I could tell my father was improving...he had started to display the mean behavior of his former life as a Drill Sargent. His tremors gone and fever lifted, he asked me to call "the good nurse. The funny-man nurse." (I love older people's euphemisms for the gays.)

He then described the care this male nurse had given him when he was scared and alone in the dark. That man had washed his face and told him that everything was going to be all right. That man changed his diaper, then his gown, and lifted him up to sit in a chair while he changed the sheets.

They sat together and watched the lady in the window disappear. Her pink duster vanishing in the wind. He had told this male nurse his sins and that man held his hand for awhile, and seemed to forgive him.

Then the pain medication took effect and my father fell into a quiet, peaceful slumber. I stood up to go find this male nurse to thank him. As I washed my hands in the sink I suddenly saw my father's face staring back at me in the mirror. It was a middle-aged version riddled with worry and yet gleaming with hope.

It hit me, this was my father's encounter with an unsung hero. The person who took care of my father and helped him through the haze of withdrawal was a good nurse. That nurse was someone's brother, uncle, friend, and someone's life partner.

That nurse was someone's son.

That nurse was me.

Can’t Get a Cab? Hail an Ambulance

2010-06-11T11:41:00.005-04:00

I wrote to Jane Fonda today.

I won’t get a response, but I wrote to her anyway. Why not? One of my favorite films is They Shoot Horses, Don’t They? It’s a classic from 1969. If you haven't seen it, then I advise you to rent it. It’s not about nurses but it could be. It's about dancing as fast as you can.

Last week at my ER, and probably like many ERs in the country, the night shift was extremely short staffed. Seven registered nurses to be exact and the hospital did not divert the ambulance patients. Is this safe practice?

Nobody minds a real emergency, in fact nurses welcome it. Bring on the sick, the strokes, the heart attacks, the congestive heart failures, the accident victims, and the stab wounds.

Bring it!

This is an ER and we are ER nurses, trained and prepared for all “notifications.” In fact we will work together to make sure patients are safe and comfortable. Healing is our job.

But what happens when the emergency medical service brings in the drunks and drug addicts to an already exhausted staff?

It takes three nurses to strip an alcoholic, clean the patient, list the property, restrain the combative patient for safety reasons, draw bloods, start an IV, give Ativan, Haldol, Oxygen, monitor vital signs, and listen to the shouts and insults for hours to come. All because of the endemic failures of the healthcare system.

A drunk is not allowed to sleep it off on the streets of NYC. The ER has become a bed and breakfast. What happens to the truly sick when nurses are wrestling with the bullshit of a healthcare system that needs to be re-evaluated? Who is monitoring this, anyone?

The EMS recently brought in a well-known homeless patient to our ER who had literally flagged down the ambulance from the street as if it were a cab. The chief complaint in triage was, “Patient reports, ‘I want a sandwich.’”

When I did my assessment of the patient, he was alert, oriented to person, time and place, ambulated well, and denied any chest pain or problems. Nothing, except, “I want a sandwich.”

The EMS knew this and still brought the patient as an emergency. By law, they have to. If the ambulance is not to blame, who is?

We have a broken healthcare system that does not care about our professional licenses. A license that we as registered nurses worked so hard to get and maintain.

The patient with the sandwich got the best possible care with a clean stretcher to sleep in, Tylenol for a hangover, and fresh clothes from the volunteer office. This patient was still our responsibility and left a happy man.

(By the way, I didn’t write to Jane about my work issues. I wrote to her for personal diversion. She happened to remind me of a cancer patient I loved and adored…one of the reasons I stayed a nurse.)

So RNs, be careful, wise, and safe. When you are short staffed, take your time with medications and take time out for hydration. We have to take care of ourselves, because they shoot horses, don’t they?

Supporting One of Our Own

2010-06-04T20:01:00.005-04:00

I was fortunate enough to receive an advanced copy of “Critical Care: A New Nurse Faces Death, Life, and Everything in Between,” a book written by a Registered Nurse. I was impressed with the fact that she dedicates her memoir “for nurses everywhere.” This indicates that she embodies the spirit and good will it takes to do our job. Theresa Brown started out as an English Professor who became a floor nurse in the trenches.

“At my job, people die,” she writes. “The antidote to death, is life.”

I realize that I am a blogger and my suggestion is just what it is (a suggestion). But I am also an RN and without a doubt I work in the trenches of NYC. Go ahead and get in the middle of a chain reaction by supporting this nurse and author. It’s perfect for nursing students and first year RNs. No knowledge is withheld as Theresa guides her audience through paperwork, physiology, and PCAs (the pump, not the sassy nurse’s aide, leave that one to me).

Remember the fear of dealing with doctors? Mrs. Brown takes us there embracing her first year like a nurse confederate. She carries wisdom, heart, and the invisible strengths of a gifted warrior. She is no stranger to us.

So, to the many nursing students reading this, T-Brown celebrates nurses, she hits the floor like it’s dynamite. “Critical Care” rocks our club with salvation and inspiration.

From T-Brown to my blog's ears:

NYCRN - What made you decide to write Critical Care?

TB - For one thing, it's a story line a lot of people can relate to: how scared you feel in a new job and how stupid you can feel while learning to be better at it. Then, you throw people's lives being on the line into that narrative line and it becomes an unusual and compelling story. I hope it will also come across as a very true representation of what it's like to be a nurse.

I'll Fly Away

2010-05-27T16:41:00.007-04:00

Somewhere between Mother’s Day and Father’s Day is a time and place for nurses like me.

My family knew starvation due to my parent’s divorce. My father’s lips kissed the tin cans of cheap beer and our family ended up in a shack on a ghetto plantation. My brothers collected dead batteries from the junk yard for lunch money and learned to hoist me into windows to steal bread from the mean Portuguese lady on the corner. More than once she cursed us and chased us with her mop. I ended up in foster care as a teenager, holding up my pants due to severe weight loss.

With the help of a social worker I begged my mother to take me in. I became the caretaker for Elaina, my half sister. At the age of 16, I scrubbed toilets after school and promised my mother I would not burden her. One day I knew I would just fly away. I made good on that promise leaving home 3 years later with my first nursing job.

Taking care of my sister had never been a problem and one day at the age of 9, Elaina came to me with a hatful of tears. She had been to court and had lost the case; according to her, "The judge told me I was a liar." My sister had been sexually abused by my mother’s boyfriend and I believed her. My mother was a pill popper and lived with a heroin addict who was quite familiar with the inside of a prison. This led to many years of silence between my mother and me, until one day she was incapable of taking care of my sister. "Please take her," she said. And I did.

I was too proud to ask for state assistance and worked many double shifts in the ICU to provide for us. I was strict, even harsher than a real father. I worried for my sister. She never laughed, and a simple smile was a rehearsed act on her part.

"I try my best to be normal," she once told me. "And so do I," was my reply.

She studied hard, so hard that she earned a scholarship to SF State. Her high school gave her an award and gave me one too: "Parent of the Month," it reads (I still have it). They never realized I was her brother. She was to be an RN, and I was proud of her. She too would have the chance to fly away.

Then one day she came to me with the same hatful of tears I saw when she was just a child. "I’m pregnant," she cried. She had just turned 18. "It’s all right," I said. "I'll work more shifts and you can still go to college." But my hopes and dreams weren’t enough.

I can still see her face when I sat with her in the clinic. "You don’t have to do this," I pleaded, and then the Nurse called her name. She didn’t even blink. She walked into my life a child and walked out of the family planning clinic a woman.

That night we watched A Raisin in the Sun, a movie about a dream deferred. What about our hopes? "Do they fester like a sore and then run?" I looked at Elaina and saw all the hurt that had tried its best to escape a pained body. At some point in her life, my sister had become just like me, a bruised soul.

Elaina never had children and we never spoke about that day. I always think about this time in my life when I triage a young female’s pregnancy. I recognize the lost innocence in her eyes and I stay completely still when the young tears are unstoppable. I give her a Kleenex and wait for the cloud to pass.

I am present, like a bird on a windowsill. I want to share my story with these young girls who feel they don't have options (but of course I don’t).

Nurses have the special job of giving unconditional care without judgement. It is our gift. It is our journey.

We live and learn, and live again from our darkest hours. Though the faces may change, the stories reflect themselves through our patients. And our personal experience becomes the human experience.

For every nurse there is a hatful of tears.

Finding a Pearl

2010-05-10T17:29:00.005-04:00

Have you ever stared out over the dark face of life’s cliffs and wondered why and how you ever became a nurse? It makes sense for a while as it pays the rent and puts a good meal on the table, but what about the heart?

When our honorable pact with compassion becomes shaken like a dry martini there is always that one moment that will bring us back (right back where we started from).

My moment happened this week on Flo’s birthday; you know, Miss Nightingale if you're nasty. The patients were connecting in the hallway like a centipede, stretcher to stretcher, in the ER. The merriment included asthma patients, four at a time, sitting in chairs sucking on Albuterol and sharing the gossip of the street. At least 2 alcoholics were restrained on my team with the usual barrage of “Let me go!”, “Untie me!” and the all too familiar, “I gotta take a piss, Lady!”

These chants can drive a nurse crazy especially when stepping over the trail of ripped-off condom catheters lying in the hallway like remnants of last night’s lust. Triage nurses were giving report to my deaf ears but I heard one word that shocked me into the present --"Isolation.” As nurses we all hate that word. It means work...and a lot of it.

The isolation room is dark, damp and lonely. I put on the suffocating mask and flimsy paper gown and walked in to find a very small woman huddled in her gurney bed shivering with chills. Her name was Pearl and I could tell she had been a pretty young girl before the AIDS had danced on her face stamping out the luminous signs of innocence and beauty.

At first I was angry, why was she placed in isolation simply for living with HIV? But then she coughed up tissues of blood before me and I had immediate comprehension of the situation. Pearl was being ruled out for TB. I felt her forehead and could feel the fever under my gloves, her sweat dripping hot like lava. She was as skin-n-bones as the stray cat I chase on my street to feed. I was aware of her abandonment by humanity and I got my nurse on. I wrapped a blanket around her shoulders. I knew she had seen enough rain, it was easy enough to recognize.

I have had my share of downpours so I said to her, “Pretend this is a rainbow.” She stared at me as if looking out of a foggy window. She didn’t understand English but somehow she knew I was going to stick her for blood samples and IV fluids. She held out her arm, I stuck her and missed not once but three times. She was dehydrated and her veins were flat, not even a streetlamp could find them. It is torture for a patient when a nurse can’t place an IV line, it takes on a feeling of acupuncture.

I became frustrated but she didn’t flinch, instead offering her other arm. She lay very still in the sounds of silence offering no complaints or ridicule as some patients are quick to do. I pushed her makeshift bed to the side and tried again, this time finding the small venous river and I smiled under my mask. She reached up and lightly touched my cheek and I knew that it meant, “You did good.”

In return I gave her Tylenol and antibiotics and then came back with a tuna sandwich and grape juice filled with chipped ice. With this small gesture she smiled with the grace of a swan, but still no song. She was alone in her room and I knew there were no family or friends. I'm always mindful about that.

She drank the juice and then she closed her eyes and I knew what she was doing, she was praying and sending her secret thoughts to heaven. She was grateful for the small moments that made her feel human again. She fell asleep as I was getting ready to leave her room, and I wished for the peace that lit up her isolation and captured my moment.

She held herself under that torn hospital blanket, and in her tranquility I heard a choir of diamonds and pearls and I knew that there was beauty in the words.

Nurses are known to wear their heart on their sleeve and our emotions sometimes hide in plain sight. I hope everyone had that sweet moment during Nurse’s Week.

And from my heart to yours, thank you for your support.

Something Twisted This Way Comes

2010-05-02T21:06:00.003-04:00

This is a story about escape.

Patti Metz was a patient of mine in Pill Hill, California. Her room overlooked a beautiful park landscaped with calla lilies and wild freesias in the spring. A special needs home dropped her off when her asthma became a series of exhausting respirations and the simple act of breathing became a crap shoot. Patti was 53 years old and was mentally challenged, an adorable woman who melted everyone's heart and became known as Patti-Melt.

After taking her blood sugar and giving her some regular insulin, I would set Patti up in the hall outside of her room to have her breakfast and watch the busy morning unfold before her magical eyes. Every now and then she would yell and wave to me as if it was the first time she had seen me.

“Hello, Honey Bun,” she would smile with barely a tooth in her wide grill. She started calling me Honey Bun because I had a sister nicknamed Honey Girl, who I also called Doo-Doo Girl because of her mean and selfish personality.

“Eat all of your breakfast Patti or I will call Doo-Doo Girl.” My mean sister became a symbol, like a troll under a bridge, and Patti would laugh and then behave herself, for even though she was a grown woman who had actually been married once, she was still a child prone to temper tantrums.

When she told me the story of her marriage I was fascinated and heartbroken at the same time. I had snuck her some Fritos and a Diet Coke, and sat with her for awhile when she said, “He beat me.”

“Who beat you, Patti?” I asked. “My husband,” she said without missing a beat and using her good tooth to crunch the corn chips. There was absolutely no trail of sadness in her eyes when I watched her chase away the ghosts with Diet Coke.

“Are you all right?” I said stunned by this revelation. Then Patti did what she did best, she recited her menu to me. “For dinner I’m having baked chicken with corn, salad with french dressing, sugar free jello and apple juice.”

“Oh my,” I said. “That’s a whole lot better than what Doo-Doo Girl will eat.”

“What is she eating?” asked Patti with diamonds in her eyes.

“She’s eating just one piece of bread with cheese.” Patti groaned and said, “Awww Honey Bun, I think your pulling my leg.” And with this I laughed, leaned over and kissed this overgrown child on her head. She instinctively knew that I was a nurse who would protect her from all wild things.

Near the end of Patti’s extended hospital stay, when the IV was discontinued and she was started on Prednisone, Nurse Irma and her cousin Penny helped me move her to a room away from the station closer to the elevator. I watched these nurses closely as everyone knew that Irma was sleeping with Penny’s husband and the tension was mounting. Gossip was a nurse’s dream and nightmare at the same time and I was praying that I would be there for the showdown. Little did I know that the tragedy of the two Filipina Nurses would have its duel on that fateful afternoon.

Penny had petitioned for Irma to come live with them in San Francisco, helping Irma settle into an American life equipped with a nice home, a good nursing job and a husband willing to help the family out. Penny was an older nurse concerned for her younger cousin’s welfare, even asking the other nurses for help. “Can anyone find a man for Irma?” she asked. (Poor Penny, she was the last to know.)

Somewhere between the bed baths, chemo infusions, and physician rounding came the sounds of a massive attack; a twisted mess of painted fingernails, dollar earrings, and pink scrub tops. But it was Patti who made the first cry. “Help!” she screamed. I had always placed her chair out in the hallway to keep an eye on her but I had no idea she would have front row seating in a legendary battle between two professional RNs.

We ran to the elevator and found both nurses on the ground kicking and screaming. “You take my husband, I kill you!” shouted Penny while pulling Irma’s hair, yanking out the butterfly hair clips of the tainted mistress.

“I lub him!” said the young Filipina as she endured a kick to the ribs.

We stood there breathless because no one dared to get in between the nurses, after all, didn’t Irma deserve it? I moved Patti back into her room but didn’t dare take my eyes off this prize fight. In the end Penny stood alone clutching the necklace of her cousin, a gift from her husband. “I am shame,” she said to co-workers who guided her to the lounge and prepared cover from the bosses; although it was already understood that nobody saw anything. The wild things retreated to their respective corners and everyone returned to the world of caring and comfort.

On the day of the beat down, Patti Metz had a Patti melt-down. I know because of one sure sign: It wasn’t the vital signs of blood pressure, pulse, temp or respirations, all those were in normal limits. It was another source of strength that helped Patti escape a twisted reality.

When I calmed her down, I listened to her lungs and they were clear. Thank god the asthma had not returned. I pulled up a foot stool, sat down, held her hand and Patti then said with the absolute clarity of an adult...

“Two pieces of bacon, buttered toast, scrambled eggs and apple juice.”

Bulletproof

2010-04-23T17:29:00.003-04:00

A couple of weeks ago I was the hottest bitch in the room, but not in the Rihanna "come do me" way, more like the "What?! I will cut a bitch" kind of way.

I had announced during a weekly staff meeting that I wanted more professionalism from my co-workers. "Could everyone please try to come to work on time?" I said with all the bosses present. "And, by the way, please don’t take extended breaks."

Now I am suffering the consequences of my simple "self-righteous" way. I am being bullied in the worst way possible, by someone I respect and admire. (And as I write this even the cat took a shit in front of me!)

It is horizontal violence and I don’t have a bulletproof vest on. I don’t even have a helmet on to prevent the cracks to my skull. Years ago I was told by someone, "The only way to your heart is through your chest with an ax." This is what being bullied feels like. It is a deep, penetrating sliver of anguish...and it hurts. It reaches to my core and causes ventricular fibrillation. Every time she bullies me my heart quivers and it doesn’t even pump.

I am walking around with the kind of vacancy in my eyes reserved for the dead. I don’t even have time for the drama, which is rare for me because I lurve it! Perhaps this RN is going through menopause, or worse, a break-up (but who really knows). For whatever the stage for her displaced aggressions, I have decided to just leap through her fire and stay true to myself.

I've been watching Nurse Jackie and I know what I must do. No, I will not snort narcotics and I won't cheat on my partner, but I will be a nurse and do the work that is expected of me. I will stay on my side of the street and do my thing. I will walk the walk and continue with the straight talk even when the message is hard to hear.

In television and film, the world of nurses is a quiet one. Nurse Jackie has the time to lay down and gossip on a church pew (this is where real nurses have to suspend disbelief). If you are an armchair traveler reading this, here’s the thing:

On the main drag of RN Avenue lives one belief, and it is all about the next thing, or the next move.
1) The next set of vital signs
2) The next medication
3) The next IV
4) The next doctor’s order
5) The next bowel movement
6) The next heartbeat
Well you get my point.

Sometimes there is no time to pee and absolutely no time for sympathy. In my life of rapid responses, the savages come out to play and there is no order. There is no quiet time, and for god’s sake, in today’s world a nurse could never cheat on organ donation. Sorry Nurse Jackie, as much as I love you and hooked on your pained expressions, I am the real thing and I have become bulletproof.

With that said I have a message for the nurses of hostility, “Fuck you and here’s to me.”

Bring it on, Nurse Bully, I am here for you. If you want me to do all the ambulance patients, I can go there, and anywhere else your mental cycle dictates. This blog is an elixir of resurrection for me and nurses like me. I can, and will, endure your fatalism.

I just ask one thing, please baby, please…Come to work on time.

Still Basking in Easter's Glow

2010-04-11T08:14:00.006-04:00

My computer was hit with an awful illness that left me without Internet access and I missed posting this for Easter. I wanted to write about faith because I am full of it.

Once, a woman wearing a pixie kanekalon sat in front of me in a classroom in Harlem. She turned to me and said, “There will be a rapture, and you and your people will not be invited.”

I wanted to pull the wig off her head, but what I really wanted was invisibility. I was wearing a simple black t-shirt and old navy jeans and doing my best to blend in with a new and unfamiliar culture, but it wasn’t working. The old me, the strong me, the loud and in-living-color me, would have always been visible: A punch to my heart could not stop my shine.

It is because of faith that I am still standing. I believe in the beauty of this world and, as Macy Gray says, “Shake your booty, boys and girls.” When I was a young man in my first year of nursing that was all I wanted to do, shake it to the left and then shake it to the right. At times I even got down to the floor. On good days I could wave my hands in the air, and yes, even spin (up until I started spinning in my own head). Everything feels right when young hearts run free, and in those days "funky" was a good thing.

Feeling funky was the “feeling groovy” of the late 70’s. I was renting a small house in Waikiki and my sister Lydia came to live with me. She turned 18 and had run away from an abusive grandmother who made her kneel for hours on uncooked rice in front of religious statues. My grandmother, who lived on a different island, had been in the witness protection program but gave up on it after living in Ohio for many years. She said, “Fuck ‘em. Let 'em find me and kill me.”

Lydia, and my friend Artrella Artrolla, took in every wayward gay living on the streets and we somehow ended up living in a house of 16 people. I made many rules and one of them was, “No turning tricks in the bathroom.” I could handle many things but I still wanted to protect my sister from the cruel life of the streets.

Lydia collected change from everyone and made a pot of beef stew and rice every night for dinner as long as I can remember. Sometimes she changed it up with a Hawaiian specialty, spaghetti filled with hot dogs. Lydia worked at an ice cream stand on the beach and would serve Japanese tourists peppermint ice cream all day. It didn’t matter what they really wanted, Lydia would take the scooper and give them peppermint all day long, and no one would dare complain. One strong look from my sister could turn a tourist to stone.

Lydia, Artrella, and I were strong-willed people with big hearts and every Easter I think of those wonderful times. I lived in a house full of laughter and flooded with tears. Everyone who came to our home entered with a broken heart.

We attended service on Sundays in a beautiful old church on famous Kalakaua Avenue and sometimes Artrella wore heels, even though he was a very handsome man. In 1978 gays were taking to the streets in butch clothing and high heels, it was a courageous act that required boxing lessons and heavy bleeding. Artrella didn’t care and showed me that the freedom to live out loud was more important than living a lie. We were the best of friends in a time of innocence in the early sunrise of the AIDS epidemic.

One evening, the entire med-surg unit in which I worked came to our house to celebrate a young RN’s upcoming wedding. Our house gave her a shower she would remember the rest of her life. Drag queens strummed ukuleles and danced the hula. Guests lip-synced Melba Moore and Stephanie Mills, and finally all the young nurses pinned Woolworth panties on the Bride to Be instead of “dollahs.” There were many cultures represented that day; Japanese, Filipino, Hawaiian, Chinese, Black and the “Gay,” with every one getting along fantastically. It was about the celebration of life and the perseverance of faith, or as the Hawaiians say it, “Fate.”

Artrella called me from San Francisco a few years later when he became ill and I left Hawaii to be with him so that he would not die alone. That is how I ended up in the City of Fog. Lydia had left the Waikiki house after falling in love with a big Samoan man. He once broke the big living room window and when I asked Faa-Faa why he did this, he replied, "Because the door was locked." That's when I realized that my sister did not know her worth, but in the days of our youth, who did?

I stayed with Artrella in the hospital on Divisadero Street where he was on an AIDS ward that was recently set up to combat this new illness. There were no miracle drugs at the time and dying was a normal thing for young men who who had once been the life of the party. Nurses were constantly walking in and out of his room.

One day, through his congestion and sedation, Artrella opened his eyes and looked towards me, almost looking beyond me. “I never knew what you really did for a living, until now,” he said, gently tugging on his keofeed tube.

“What do you mean?” I asked.

“These nurses have the warmest hearts. You can feel their hearts when they enter a room.” And then he said, “Thank Lydia for all that stew. She had nothing but gave everything...just like her brother.”

He was right, having nothing but giving everything is a way of life for my people…and the vast majority of nurses.

One day, after the feeding tube had been pulled, Artrella asked for some french fries. He put a few in his mouth and didn't chew; “just for the taste.” I reminded him of the peppermint ice cream we used to eat in front of Lydia’s stand, and how the warm ocean waves would curl under our feet as the sun dropped in front of us, exploding in the rapture of a Hawaiian sunset.

Artrella Artrolla was cremated and carried across the Pacific inside his favorite possession, a Gucci cabin bag. His fate all wrapped up in his faith. To this day I wonder if my best friend showed up in heaven wearing rubber slippers or high heels. I may not be certain of his footwear but my faith tells me this, when he knocked on heaven’s door, an angel let him in.

The Nurse Who Gloved Me

2010-03-28T11:00:00.005-04:00

A person on the Facebook fan page posted this comment that inspired me to write about the view from an LPN’s perspective.

“I’m an LPN and all I ever hear is RN this and that, LPNs are just as good and as important. But we don’t get enough credit for being a nurse. It’s only if there is an RN after their name.”

I am an adaptive enigma.

I became an RN in the second half of my life after spending many years as a Vocational Nurse. I was comfortable in my life and was very experienced in the ICU, cardiac step-down, med-surg, oncology, medical psychiatry, orthopedic and HIV care.

I was familiar with the work and my critical thinking was comparable to most Registered Nurses, but my frailty was the math, and by that, I mean basic math. I could pass medications with ease, as I could do any problem in my head, but the written exam was more difficult than any Swan-Ganz catheterization I’d ever assisted. I could quote Shakespeare and Kierkegaard, study the analysis of Jung and Freud, but the analytics of simple arithmetic was as elusive as connecting a VCR in the early 80’s. The fear of math became as oppressive as many of the Nursing Managers I had encountered in my career.

Here's my personal root cause...

I initially became an LPN because of an extremely difficult existence. The life of nursing chose me, I did not choose it. My mother left the family because of a pregnancy unknown to my father. She began a life of welfare, street-walking and pill popping. She worked nights for “under the table” pocket money at a sleazy and dangerous nightclub in the red light district of Honolulu. I left the foster home in which I was placed to become the baby sitter of her last child. I had two shirts and one pair of pants when I moved in with her and walked three miles every morning to finish high school.

I could have handled my responsibilities without any problem except for the abuse I endured from my mother’s mental illness and her very large and savage boyfriend who became our tormentor for many years. I wore long sleeves even in the hot sunshine to cover the bruises.

I became an LPN to escape my circumstances and to this day I believe becoming a nurse saved my life. I never studied in school preferring to smoke marijuana before and after class. To this day I wonder how I passed the exams and, more importantly, the state board. There is a powerful innate guardian that gave me the strength and courage that it took to change my first adult diaper, and the patience to walk an old person to the bathroom.

My first inclination that the nursing world was bigger than me was when I gave 2 tabs of Tylenol with codeine to a young mother with a mastectomy. I gave them to her without any water and left them on her bedside, causing her to reach over her painful incision. She turned on her light and I found her crying. When she told me what had happened I hung my head in shame. I was so young and self-absorbed in my own drama that I could not see the big picture that my life was taking.

I had dancing talents induced by Grand Marnier, so how did this happen? This life of IV fluids, Foley insertions, bowing down to doctors and nurses with degrees was a harder than I had anticipated. The view from an LPN’s world is an oppressive one filled with difficult patient care assignments and a monster on your back: The monster of knowing that you could do better with a little more education.

One day in San Francisco I was banned from attending an important meeting for Registered Nurses. My friend Mary Grace Sanchez, an LPN co-worker, snuck into the meeting and raised her hand and said, “LPNs work hard too.” The answer from the manager was, “If you want to complain about it, I suggest you go to school.” Mary was then escorted out of the meeting.

“That's it!” I said in disbelief. Going to school had crossed my mind for decades and it took a selfish, inconsiderate Nurse Manager to put me on the right path. She became the nurse who gloved me. That very day I enrolled in the basic math course at the city college and Mary Sanchez applied for the PA program at Stanford University. (She’s now making 6 figures.)

The writing on the wall was always there for me but I didn’t want to read it.

I walked in the darkness from the BART station to the City College of San Francisco to my first math class and I was surprised to see many other LPNs and aides in after-work scrubs doing the same thing I was, simply trying to “Move on up.” The walk I took always reminded me of the three miles it took to get to high school, only this time the bruises were internal.

The life of an LPN is not an easy one and the only way to get ahead is to reach out for higher education. I think of my first patient and her mastectomy. She had to reach out and feel the pain from her recent incision to get what she needed the most…relief.

For the nursing students and LPNs who are reading this, find your personal moment of epiphany and let that moment glove you.

Wake Me Up Before I Go Go

2010-03-19T22:44:00.004-04:00

Working in New York City is not a Broadway show, but there is a whole lot of drama. Employees of every job description hear the whistling of the crazy train and somewhere there's a conductor yelling, “All board!”

There's Juanita, the triage nurse who needs to clean everything with 70% alcohol soaked on a Kerlix roll before starting her shift.

“Good morning, Juanita,” I say still feeling tired and sleepy and just wishing this were all a dream. “No one talk to me!!” she says with her tongue hanging out like a lost puppy. She scrubs her desk, chair, computer, and blood pressure apparatus like a scene from Porgy and Bess. (The main character sang Summertime while scrubbing the floor on her hands and knees.)

The living is not easy for people like Juanita who isolate themselves from the modern world. Once I asked co-workers why this RN was hell bent on her twisted ways and the reply was, “Leave her alone, her husband left her.”

“Oh???” Snap.

Then there's Miss Kimodo, dressed in lace and pearls over faded Dickies and screaming about her assignment.

“Don’t gang up on me!” she yells as her facial pancake collapses and her eyes turn into little slots of eyeliner like a wilted Madame Butterfly. She runs from me grabbing her temples like she's holding up a facelift. It is only the start of the morning and she already breathes fire.

Once I asked the others, “How can we help her?” and I was told, “She needs a man.”

“Oh???” Snap.

Then there's Sara-Belle Palsy, a princess from her village, now just an RN from Staten Island. This is a woman who called the union on me for allegedly calling her a “Psycho.”

“I did not call you that,” I said calmy in the meeting. “I merely suggested that the mental health clinic is available for you as a walk-in.” Miss Palsy then stood up and did a jig and salsa that could rival any dance from West Side Story. Yes, I too “Like to be in America,” I sang in my bubble.

When Ms. Kimodo and Sara-Bell Palsy are both working together, the hum of the choo-choo can be heard a mile away. It's definitely a little train that couldn't and I'm feeling worn out.

I think of the crazies in San Francisco and I miss them...

There was Lotta Cox, the RN who wore spandex and chewed on chicken skin at the heart monitors. Mary-Ann, the mongoose who reported everyone and ate frozen Snickers bars for lunch. And who could forget Wanda, the black secretary who wore short blonde wigs, blouses from Sizes Unlimited and dressed as a pubic hair on Halloween (Yes, you read it right: a pubic hair, and she sat next to a can of coke).

And of course there were the identical twins, Millie and Muffy, Nurse's aides who were both lazy and crazy. If Millie were scheduled, Muffy might show up in her place. We knew the difference because she loved to read the bible at the nurse’s station.

“Muffy, could you answer the patient’s call light?” I would ask testing her patience.

“Fuck off, can’t you see I’m reading?” Then she would slam shut the book’s leather binder, scaring the other RNs.

“Of course,” I say. “Jesus saves.” Snap.

The only time Muffy and Millie jumped from their seats was for the platter of “Safeway” cake in the lounge.

Those were the days, I think.

If only life were an IPOD, there would be sweet moonbeams, strawberry avalanches and exploding stars (a musical reverie). Instead, I crawl through the corridors of a busy hospital and listen to the menu for the Nurse's Day pot luck.

“It will be fabulous!” says the Brooklyn gay in a large Tropicana- style shirt resembling a character from La Cage Aux Folles.

“Last year I bit into a neck,” I say turning my own neck and handing over twenty dollars.

“I told you that was a tail!” he exclaims marking my name as paid. (Oh! For all that’s holy, ox-tail at a luncheon?!)

Then I can’t help myself and ask him, “Are you wearing a muu-muu?”

“Bitch,” he politely says back and we laugh like old friends.

I'd be a rich nurse if I had a dollar for everyone who called me that, I think.

Just last week I was walking past the elevator when I saw a female employee lying down on the ground with her manager holding open the door. I recognized this employee as one who loves to be triaged while on the job (headaches, cold symptoms, pimples, you name it, she’s gotta have it.)

“Why are you on the floor?” I ask in disbelief. As she looked at me with her head in a 90 degree rotation I hear her say to her boss,“Not that bitch again.”

About an hour later I see the same employee 100 yards from the hospital entrance standing and having a laugh with her friends. She was sucking a cigarette in one hand and holding a work release slip in the other. She looked at me harshly with the glare of chain-gang eyes and I say to her, "Ain’t life a bitch?" Snap...

No, now a really loud 'snap, snap, snap'...It's the sound of an alarm clock clearly waking me up for another round and as I look up to see 4 hungry eyes in the darkness, I hear the sound of my better half saying, “Do you work today?”

It is then that I realize why I never bought a ticket for the crazy train. It's as clear as the coming spring weather. After I put on my own faded scrubs, grab my glasses, cellphone, look for my wallet (Coach, of course), and then feed the cats, I know why my life isn’t so bad: it’s because I am loved.

And, somewhere deep within me, I believe I'm really in a musical and that love can fix anything, even for a worn out nurse like me.

Fitting In is All Up to You (2010)

2010-03-14T08:59:00.004-04:00

The muffin top has established itself as Emergency Room couture. Some clerks in NYC love, love, love the muffin top.

According to Wikipedia: A "Muffin-top" is a slang term used to describe the phenomenon of overhanging flesh when it spills over the waistline of pants or skirt in a manner that resembles the top of a muffin spilling over its paper casing.

I was woefully ignorant of this fashion statement when I asked the meanest clerk of all, "My dear, when is the baby due?"

"Tell me, you did not just say that!" I quickly realized that I had entered into uncharted territory. "Oh no he did-ent," her tone increasing in strength.

It was at that moment that I understood that all the leggings I saw meticulously tucked into boots (without the pants) were meant to be fashionable. The elegance of the Bronx and the crown jewel of Brooklyn personified.

My friend Christmas Madamba, a new and exuberant RN, came to save me from the army of wigs that started to confront me. Clerks had begun to encircle me.

"Come here and let me show you my new black dress from Marshall's," said Christmas. She then tried on her dress in the back of the trauma room and when she came out, I stood in shock.

"What size is that?" the words seemed to spill out of me.

"It's a size 10," she giggled as she spun around.

"But you're a size 16?" I answered, while emptying a disposable urinal into the sink.

"I know, isn't it fabulous?"

Christmas was a free spirit, but highly inappropriate. (She once asked another RN, "Auntie Mae, have you ever had cunnilingus?" Poor Mae, she dashed out of the station almost choking on her Dunkin Donut.)

As Christmas Madamba stood there smiling at me in her stretch-limo jersey knit, it dawned on me...I don't think I fit in here.

Christmas was about to change back into her scrubs when she proceeded to tell me about the massage she received from a man with a pony tail.

"He reached in under my panties to massage my buttocks."

"Under your size 16 Lane Bryant's?" I asked.

"No, silly. My size 8 JC Penney's!"

And with that she skipped away without a plus-sized care in the world.

It was then when I learned a truly valuable lesson: sometimes in order to fit in, you actually have to make things fit you.

A Nurse's Manifesto (2010)

2010-03-06T11:13:00.001-05:00

I'm stepping up to the plate and out of the box.

I'm a real Nurse: Not the kind of nurse who's stuck to the seat with Elmer's glue, or the clipboard nurse in a starched lab coat looking for errors, or even the nurse who is perpetually late.

I am not an rn (resting nurse).

I'm a Warlord Nurse, marinating in overtime, who fights for integrity and compassionate care.

Recently, I announced over the ER intercom that I needed the attention of a nurse's aide, "Could a competent nurse's aide please report to the station?"

There was work to be done and I needed help. And you know what? No one came forth.

Later that day, a supervisor came to the triage area and stood over my shoulder to reprimand me. Instead of having him look down at me, I offered him a seat.

"Talk to me as a man," I said. "More importantly, talk to me as one RN to another."

"Did you announce that you needed a competent nurse's aide?" he asked.

"Yes I did."

"Why did you do that?'

"Because it's what I wanted. Because it's what I needed. Competency is what we all want, especially our patients."

He was stern in his efforts to counsel me, and then he asked, "What if I went on the loud speaker and asked for a competent RN?"

Without hesitancy, I replied, "I would step up to the plate."

(I hold my pee, my glasses are lopsided and frame puffy, tired eyes, but I keep moving, and my co-workers never have to look for me.)

Regarding lazy nurses and aides: A wise Nurse Chen once told me, "A crow is black all over the world."

Then she would go into the pantry and eat bitter melon, (raw).

Nurse Chen was hard-core, but she was hard-working and never suffered from indigestion (nor indignation).

I eat bitter melon of a different kind.

Every time I suffer the indignation of a physician who yells at me, I swallow...

Every time a nurse's aide rolls their eyes when I ask for simple vital signs, I swallow...

Every time a nurse hangs up on me when I'm trying to give report, I swallow...

I protect and serve. I am a health care soldier.

I belong to the division called N.U.R.S.E.

Necessary
Unsung hero
Resilient
Selfless
Essential

It begins with us...and ends with us. We take all the bitter melons and make melonade.

I am stepping up. And I am demanding respect.

I'm a real N.U.R.S.E.

Can I get an Amen?

The Spy Who Came in with a Cold

2010-02-27T07:41:00.003-05:00

She kept waving to me from her room (this very large 400 pound woman I wanted to ignore). Did she want a straw, or worse, did she want help to the bathroom? Oh god, that would take forever, I thought.

Finally, after numerous attempts to get my attention, I went to her. She smiled, took my hand and said, "You’re the nurse that scrubbed my vagina." I gasped and clutched my pearls (but wait, being a man I didn’t have any pearls, but I did have a stethoscope, so I clenched it) and said, "As lovely as that sounds I think you have the wrong nurse."

I turned to walk away when she said, "It was you all right. I pee’d all over the stretcher and you scolded the girls for leaving me that way. It was a couple of months ago. I was so embarrassed but you helped me through it. Thank you is all I wanted to tell you."

They pop out of nowhere these "thank-yous for yesterday’s care" that they almost seem to compensate for the pop-ups of the Secret Shopper.

Yes, the fabled Secret Shopper. It's a surprise attack of a vicious nature that guarantees to enthrall and captivate a triage nurse. It is not a myth of the nursing world. The Secret Shopper exists and I am imprisoned by two memories...

Lady One sat down and informed me of a seizure she endured while sitting in the waiting room.

"You had a seizure?" I said mystified while taking her pulse.

"Yes, while I was waiting for you to call me," she answered while dabbing her lips with cherry Chapstick.

Just then her hand trembled and the Chapstick fell to the floor. "See?!" she told me. "It happens and I have no control over it."

"That was a seizure?" I said with disbelief, but turned to grab a stretcher from the ambulance bay. I rolled it over to her and guided her onto the rough mattress when she exclaimed, "Don’t give me any Ativan! I’m allergic to it."

A seizure patient allergic to Ativan was a red flag, not to mention her glazed over appearance. It’s like talking to an owl, I thought, and knew she was up to no good.

Lady Two, sporting a lopsided mullet, was a spy who did not love me. Before she sat in the chair she asked me in a British accent as authentic as Madonna’s, “Where do I hang my coat?”

"You can place it on that chair." In my head I thought, Right next to the drug addict, biyatch.

"But it’s an Ann Taylor," she professed while laying the coat down. (I must admit, labels are a way to my heart.) But then the drug addict lovingly stroked the jacket claiming, "I love Burlington Coat Factory!"

"Oh?" I said devastated at the thought. "Whatever do you mean?" said the spy.

When I asked the patient her name she said, "Oh, I’m not here for that. I just want to see the doctor for my cough." It was then that she started coughing a cough so fake and forced that I was surprised the academy had not nominated her. It went on and on like a thrown-up hairball.

"Please offer me a napkin," this time the accent was Scottish. (Susan Boil-ed over).

It was then I realized I had to react to this Secret Shopper, so I handed her the Kleenex and started to complain about my dull, chapped hands. "I’ve been washing them all day," I said. "Look at how brittle they are."

The Shopper was horrified to see the cuts on my knuckles and proclaimed, "I’m not here for that."

Realizing this woman was doing a horrible job convincing me that she was a patient, I asked her where she lived in NYC.

"I live on the West Side," she answered. But after I named a few restaurants and bars she said, "I live on the East Side."

I was clearly beside myself when I asked her to put on a mask since her coughing proved as uncontrollable as her lies.

"A mask?" she asked with astonishment. "But I’m not here for that."
That's when I escorted her to an isolation room and notified an ER doctor.

Every day we face the challenges of a career that can kick us in the ass and tug at our heartstrings at the same time; a seizure of morality and dishonesty. I accept that “secret shopping” can reward us with positive changes, but at the same time it feels like utter harassment (like taking a bullet for the cause). The daily strife in our jobs is counter-balanced with the simplicity of a generous "thank you."

Hail the clean vagina that left me so starry eyed. "I'm here for that."

The Young Are Not for Eating

2010-02-21T20:58:00.003-05:00

In my first nursing job I was bullied by the Lieutenant and the General. I was on a simple med-surg unit, not in the military. The Lieutenant was a spinster named Marta and the General was an overweight shorter woman (about 4ft 6in.) who resembled a poltergeist.

The General would check my completed dressing changes and then write me up for not doing them. The Lieutenant would time my lunch breaks and give me the hardest patient assignments. I hated them. I was called into the boss’s office once a week and my file was stuffed with their numerous complaints.

The viciousness of the old school was a rite of passage I wasn't prepared for. It was a silent stranger that was poised to damage the belief I had in nursing. How could we be kind to patients if we were unkind to one another?

Head Nurse would say, “You keep bedside dirty, you no answer call light, you take long lunch break, you put Kibbles ‘N Bits in Marta’s lab coat.” Head nurse was from Japan and when she was angry her eyes would close in on themselves displaying the tortures of Maybelline. “What you have to say?”

“I did not put dog food in Marta’s coat pocket,” I said politely, wincing at the thought of such a cruel act. I was telling the truth; it was Kit ‘N Caboodle (I had a cat).

In the days of team nursing a medication nurse would give the meds for 32 patients. Once, I missed a multivitamin, the General caught the mistake, I called her a midget, and I failed my first probation. The Regime had won or so they thought. Head Nurse liked me and gave me another chance.

I worked harder than ever, kept my mouth shut, and passed the second attempt. No one had warned me that nurses eat their young. They didn't teach that in nursing school.

Later, when I moved on to another job, Head Nurse revealed why she gave me another chance and it surprised me: She liked that I was not ashamed of being gay. To her it showed true courage; she knew the world was changing and she would change with it. She was all too aware that there had been destructive nurses in my path and that they had failed to reduce my self-esteem.

When the military showed me their guns, I pulled out a cannon. I gave 100 percent: I took short lunch breaks; I put beautiful bows on the dressing changes with labels and dates; I constantly emptied wastebaskets; and I triple checked my medication sheets. With the guards standing close, there was no room for failure.

In other jobs I have found there would always be a General and Lieutenant; as well as a Mongoose, Rat, Weasel, and Snake. These are the nicknames of the nurses I’ve encountered who hold prominent positions in my memory. It was the Mongoose who told me, “There are 100 ways to get a nurse fired.”

Nurse Chen, a friend of mine, described these frenemies, “Crows are black all over the world.”

In this new world of nursing there is a term called horizontal violence that describes the old school of bitterness and oppression. When nurses form cliques to seduce powerlessness in the young, they are perpetuating a nursing pathology that condones aggressive behavior. I call this a Regime and it can reside in any med-surg, ER, rehab center, ICU, and Labor and Delivery Unit in the country.

The Regime can be found in Australia, Canada, and even the Philippines. Nurse to Nurse hostility is a universal destructiveness that has a negative impact on the nursing world.

I am encouraging nursing students to speak up in class about this topic. Bring it out into the open and expose it. It is the ugly sister of the nursing community. Isn’t it ironic that, in the spirit of healing, lays a culprit that is psychologically toxic?

To the nursing dinosaurs (including myself), it’s not too late to change bad habits. Instead of generating internal conflict, let’s help the young nurses with our experience and wisdom. I urge everyone to stamp out horizontal violence. Petition those nurses who sabotage and create disharmony.

In every nurse lies a bloom of hope that can nourish the excitement of a young nurse. Try and remember why you became a nurse in the first place. Don’t become a perpetrator of "burnt-out pessimism." Instead, become a cultivator of workplace integration...as well as a phenomenal nurse.

Break the cycle. End the silence. The world, it is a changin'.

If My Heart Were a House, You'd Be Home By Now

2010-02-12T19:23:00.005-05:00

Bree is an RN who worked years of overtime and bought herself a vagina. She had been a man long enough, even serving in the army. I met her over 20 years ago in a private hospital in San Francisco.

She was dressed in purple scrubs with the hairstyle resembling a cockatiel. At first glance she looked like a housekeeper dragging along a linen cart and fetching ice water.

“Howdee!” she said to me in a booming voice that jiggled the small cowboy boots on her earlobes. This began a lifelong friendship of two misfit nurses and their little trip to normal.

All her life, Bree dreamed of womanhood; thinking her past life was enchained in sorrow. She didn’t lie on the hospital application, a nurse recruiter marked “female” for her. She deferred a pelvic exam and altered the big M on her state ID. She lived her life privately and counted on the “Times they are a changin’.” She was certain that one day she would be accepted as a transsexual and she would be silent until that day came.

What Bree hadn’t counted on was that people would talk (and they did.) What they said was that she was a damn fine nurse. It never mattered to anyone that Bree had a penis. It only mattered to her.

I am dedicating this story to the young lady from Mississippi who is in nursing school and wonders what it takes to be a good nurse. It takes discipline, perseverance and the willingness to change in the face of a struggling economy and the continued march for civil rights. The Nursing world never stays the same and personal growth is essential.

The best way to honor your life is to serve humanity: Nurses live by this creed. Treat every problem with compassion, especially your own.

If you have ever needed forgiveness from another human being for doing something so insane, remember how that felt. There is that small window between love and hate and it is called compassion.

If you can feel this for yourself, and for others, then you have everything it takes to be a nurse. Treat your heart as a home and come into it as often as possible. Never accept that you are, “Just a Nurse.”

What makes Bree shine is that she’s a patient’s advocate. I watched her stop resuscitation when she waved a signed DNR at an MD. She stepped to a patient’s bedside and said “No, you don’t!” when a doctor tried shoving an NG tube down her patient’s throat for forced feeding. A good nurse listens to the life histories that make someone unique and significant, and is well aware of their wishes.

On a personal note I would like to point out that Nurses are human and vulnerable to the drama of life. Try your best to keep it out of the workplace. When you are on the job, be there and give 100 percent. You will be respected, I guarantee this. Your personal problems at home will wait for you. (They always do.)

Also, be aware that “once a nurse, always a nurse” and you become a representative of the profession. Find culture in your life. Go to foreign films, art exhibits, plays, and read novels. It is your responsibility to stay in tune with politics and current events.

When I met Bree, I taught her how to swirl and sip a fine Cabernet and she taught me the basics of self-actualization. To this day when we see an art film she tells me, “Nothing happened.” And I say, “In between the beginning and the end, life happened.”

I would like to tell every nursing student to feel your life and love what you feel.

When I was in nursing school a very wise nursing professor once said, “Don’t tell me you’re a good nurse, show me you’re a good nurse.” I can still here her voice in my head saying that phrase over and over again. The exhibition of our work performance will trumpet the profession.

On Valentine’s Day I remember Bree every year by sending her a simple card and gift to salute our personal triumphs in maintaining a friendship that began long ago in a hospital corridor.

After her surgery, I bought her a beautiful white linen and lace panty to celebrate her new found spirit. Her peesh encased in luxury, something that said, “Welcome to the party.”

I asked the salesgirl for the largest size (which we snipped off with a pair of scissors). When Bree and I went to dinner with friends I could tell by her small steps that the gifted lingerie was killing her.

“Bree, how does the panty fit?”

“Wonderful,” she said, and just like a woman she announced,"But it’s so loose I’m swimming in it!"

Happy Valentine’s Day to the nurses of the future! (Summer, Megan, Ayun, Kristen, Amy, Laney, and Georgia)

A Winter Pain-ting

2010-02-04T20:57:00.040-05:00

Pain is the fifth vital sign. Deciding fact from fiction is the hard part. A patient's affliction is a visual sting; a silent movie, a spy of the mind's eye...click.

An ordinary day in winter. I wait at the bus stop in darkness, swathed in Lacoste and Columbia, but still never warm enough. I miss the Hawaiian sun, the smell of plumeria and the sound of Waimanalo Beach and its ocean.

I study faces, observing the different expressions that will hone my craft.

I learned this years ago when Phyllis, a ward clerk, walked off the unit to look out a window.She stood there silently watching the leaves falling off branches and I asked her if "things were all right."

Her weathered face, quilted with desolation, said to me, "I just need a moment."

I couldn't help but memorize her "moment." Her face etched in my memory. She was transfixed on some far away land.

I have become a master fortune-teller of stolen glances. The hospital is a haven for broken dreams...

I once saw a husband lose his young wife to a jet ski: a 5-year-old boy had run over her, turning the ocean blue and red. He made no sound as I watched his silent horror. His face an earthquake of raw emotion. Click.

I look at the listless faces on the NYC subway, a morning montage of grim rush and poor civility. Sometimes my own fatigue and daydreams lead me into Queens. (Oh god, I think to myself after missing my stop.)

I watch the face of a Nurse's Aide, bundled up in rabbit fur, smoking a cigarette in the snow. "The RNs are lazy today," she tells me as we watch a squirrel jump off the stone wall.

Later, I see Miss Kimodo's face yelling at me, her thick make-up cracking under the pressure. She's an old maid, I ponder, and her bitterness is hostile and disruptive. Just stay focused, I tell myself. Don't react.

Dr. Bonet stands in the corner of the Code Room eating salt and vinegar chips, washing them down with Diet Coke while chatting on her cellphone. Her boyfriend didn't show last night and she is not amused. Click.

The classic rumble of the ER begins with a train of ambulance patients hogging oxygen and shouting obscenities. "You stupid nurse!" I hear this behind my triage chair. An ordinary day, I think.

A man walks in with his hand wrapped up in old bandages and sits quietly in the chair next to me. Saying nothing he hands me a coffee cup full of ice. I smile and say "Welcome."

His face is fraught with obscurity as if Dali painted him. Yet underneath the oil, this painting is screaming. Click.

I recognize this look. It's the same look Phyllis the ward clerk had when she needed a moment. I start to panic and I look into the coffee cup. Staring back at me is a finger, lifelike and absolutely real. This patient was in pain, real pain. Not the twisting, writhing histrionics of a drug seeker.

I rush him to the trauma room where treatment begins, a blood pressure cuff is used to stop the bleeding and the day becomes less ordinary. I silently thank Phyllis for the mental picture I took of her face that day. It was an expression of true pain, so subtle that only a poet could capture it.

Phyllis died homeless and a crack addict and her "moment" served as an epitaph. A last word. No one could stop the bleeding.

As Nurses we must commit to memory all the experiences that will epitomize a career of healing.

When I leave work that night, I hear Miss Madamba, a young caring nurse, tell a patient, "Awww, it will be all right." Then she holds a cup of water to her patients mouth helping her with every sip.

And I know even in these chilly scenes of winter, a nurse's warm heart exists.

Then I tell myself the same exact thing, It will be all right. Click.

Is That All There Is?

2010-01-29T18:27:00.018-05:00

I taught my siblings about death the day we cremated "Gung-Ho," the family cat that died of starvation. (It was tough times for all of us the year we lost our home.)

We wrapped him in an old T-shirt, marched to the dump site, and watched him burn with some matches and old newspaper.

They wept one thousand tears that day while we endured the wretched wrath of one thousand mosquitoes. We watched as the flames painted the colors of sunset and I said, "Look, his spirit is racing into the sunlight."

Then we celebrated his life with all we had available, Bisquick and fried rooster...the remnants of a cock-fight.

I carry the warlike sentiment of a trench nurse. I trust my name tag, it identifies me. It says "RN" and I consider that a privilege.

An administrator asked me the other day for my titles and I said, "Staff Nurse."

"Is that all there is?" she asked with a disturbed and perplexed look on her face.

My feelings were hurt but I remained quiet and poised, as a flashback dressed in melancholy laughed its way into my head...

Her name was Gloria and she would soon be dead. Her belly swollen with years of cheap vodka, her skin a sordid shade of yellow, and her hair a twisted-up bird's nest.

I was working part-time at a hospice called Heaven Knows when she called me into her room one evening.

"I was a horrible woman," she told me.

"Why do you say that?"

"My son hated me. All I ever did was drink. I would shut the door on him and drink alone in my bedroom."

I handed her a cocktail of Roxinol and Lactulose and, before taking her medicine, she pointed up to an area of the ceiling.

Oh good, I thought. This is where the patient tells me about the night visitor.

Normally, before a patient passes away it's common for them to see a dead grandmother, husband, or angel who will guide them into the "light."

All nurses love hearing these stories as it gives us hope for an exciting afterlife. I have many friends who were killed by the tragedy of AIDS and I hope there's a party full of gossip and tight jeans waiting for me. Gloria interrupts this daydream.

"It's there in the corner," as she reached out with her long, twisted fingernail.

"What's there, honey?"

"A small, gnarled demon," she said softly (scaring the hell out of me).

"It's waiting for me," she continued. "It's got jagged teeth and one eye. It laughs at me all the time. I'll be dead soon. I was a man-eating tiger you know...a real bad girl."

"Heaven doesn't want me." She was defeated.

I had never in my entire career heard a patient say that to me. I was alarmed and concerned for her so I sat on her bed.

"I'm sure it will go away," I said full of uncertainty.

As I was leaving her room she whispered, "Your demons never go away, you know."

I shuttered at this, but in my head an old and familiar song played: Gloria, I think they've got your number.

I was right.

She died an hour later. I knew this because Old Man Brown in the next room woke up screaming, "Gloria flew through my room." Then he snickered, "Just like the witch she was."

I called a hospice aide into the room and we did the death tango. We washed her body in a small amount of vanilla, brushed her hair, dressed her in white, and then I placed tags on her toes and wrists. The tags that would identify her as a patient, nothing more and nothing less.

I was about to walk out of the room when I saw the stain of her lipstick on a Dixie Cup near her bedside. This was her final moment of integrity, I thought. A sip of water and a moment of truth...and I was her witness.

As nurses, we stand at the gateway. And there is always a departure. Sometimes it's a peaceful one, but in Gloria's case only "Heaven Knows."

We are special people and I'm reminded of that every time I put it on: my name tag.

The one that reads, "Staff Nurse."

And no, "that's not all there is."

A Mangoes Home

2010-01-22T16:31:00.034-05:00

Everyone will encounter an unsung hero. It may not be a firefighter, or a lawyer, or even a politician, but there is one guarantee in this life:

Everyone, at some point in their life, will encounter a Nurse.

My father once loved a prostitute who wouldn't marry him. Instead, that red-headed "taxi dancer" said "Marry my daughter," so he did. And that's how my parents met.

My mother was 15 and my father a 22-year-old boxer in the Marines. What was to follow was La Vida Loca personified.

Many nurses walk around with an idea of quality health care without paying much attention to the reality of it. That is, until the person needing the care is their sister, brother, favorite uncle or, in my case, a father; a father who in his retirement spent a lot of time drinking Budweiser under a mango tree (in the can...never the bottle!).

Under the life of that giving tree was where my father reflected on his own life:

He thought about his 8 children and his baby girl who died while he was in Vietnam.
He thought about the mother of those children, his crazy wife, whom he loved heart and soul, and how she left him pregnant with another man's child.
He pondered about his oldest son, a gay male nurse. "If only his mother had cooked more vegetables," he told his friends at the Veteran's Center.

My father spent so much time on the nails of nostalgia that he ignored the nail under that mango tree. The one he stepped on.

Life continued this way until he ended up in a hospital bed with a black foot and freshly amputated toes. He was a diabetic as well as a drinker.

I flew home to Hawaii to find him in full-blown withdrawal, in a hospital room on the 7th floor.

"She's at the window," he said, his hands displaying all the tremors of an alcoholic.

"Who's at the window?" I asked.

"Your mother," he answered pointing towards the mountains. "She's standing on the ledge wearing her pink nightgown. She wants me back."

"Dad, mom is dead. Besides she could never fit on that tiny ledge, she weighed 250 pounds."

Then I heard the sound of shells. No, not the pearly shells from the Pacific, but the shells from a chicken. My stepmother was sitting in the corner of the hospital room eating boiled eggs and rice balls. She was Filipina and never tired of saving money.

"Auntie Rose, didn't you smell my father's rotten foot when you were at home?"

She looked at me annoyed and said, "Of course I did! I thought it was a dead rat."

Just then the surgeon entered the room placing a consent form in my hand for a partial foot amputation. "The infection is getting worse," he explained. "This might slow it down."

"You just cut off his toes, now you want half the foot?" I cried with disbelief.

The surgeon was a about to write me off when I told him I was a Registered Nurse and would not tolerate the "Chop-Chop."

"This is a leg, not a rack of lamb," I shot back. Then I boldly said that I wanted him to perform a below-the-knee amputation. "Cut off the leg," I said. "It's what is going to happen anyway. There will be no chop-chop with my father. He's strong enough to use a prosthesis when he's well."

The surgeon gave a concerned look and said, "What is that smell?" After eating half a dozen boiled eggs, Auntie Rose had started to fart, quickly dispatching the surgeon.

The day after his surgery my father was hysterically blaming his primary nurse for his missing leg. As soon as she walked out of the room he yelled, "That fat nurse cut my leg off! Don't let her near me again!" I could tell my father was improving...he had started to display the mean behavior of his former life as a Drill Sargent. His tremors gone and fever lifted, he asked me to call "the good nurse. The funny-man nurse." (I love older people's euphemisms for the gays.)

He then described the care this male nurse had given him when he was scared and alone in the dark. That man had washed his face and told him that everything was going to be all right. That man changed his diaper, then his gown, and lifted him up to sit in a chair while he changed the sheets.

They sat together and watched the lady in the window disappear. Her pink duster vanishing in the wind. He had told this male nurse his sins and that man held his hand for awhile, and seemed to forgive him.

Then the pain medication took effect and my father fell into a quiet, peaceful slumber. I stood up to look for this male nurse to thank him. As I washed my hands in the sink I suddenly saw my father's face staring back at me in the mirror. It was a middle-aged version riddled with worry and yet gleaming with hope.

It hit me, this was my father's encounter with an unsung hero. The person who took care of my father and helped him through the haze of withdrawal was a good nurse. That nurse was someone's brother, uncle, friend, and someone's life partner.

That nurse was someone's son.

That nurse was me.

Mending a Torn Jersey

2010-01-14T22:29:00.005-05:00

There's one thing I know about love: It can show up in your life and then drop dead...literally.

My first bout with a broken heart was in my first year of nursing. "This feels worse than the flu," I told the employee doctor. She was an older woman and wrote me a prescription for Thorazine.

In the late 70's, some MDs still believed that being gay was a mental illness. Even my own mother gave me some Elavil (which knocked me out for 2 days). But I was just a heartbroken gay, not a psychotic, so I knew an even better remedy: I danced. I may have been an emotional mess but I was grateful that I could still feel my life.

I emptied the bottle of Thorazine into the toilet, wrapped my lips around a bottle of Jack, and danced until I wore myself out.

I was beat and I turned the beat around. As a 20-year-old, love's suffering felt like the end of the world, but I slowly realized it wasn't.

The love pains that lingered inspired me to become a better nurse; I knew what physical and emotional pain felt like. It also helped me to recognize the walking wounded...

I was living in San Francisco and worked with a nurse named Lola. She was an RN from New Jersey and wore the stain of heartache like a swashbuckler.

There was a "living out loud" quality about her that I detected the minute she came to a staff meeting in tights and a short leather jacket. Our Head Nurse, however, was livid.

"Lola, you have no pants on!"

"This is the style in Jersey," she explained.

None of us had ever seen boots with tights before but Lola from Jersey had a wicked rack that compensated for it. She had long hair that shined like black shoe polish accentuated with devilishly pumped up bangs. (Think Snookie from Jersey Shore.)

The Filipina nurses envied her.

"She look berry pritty and I lub da make-up even when she look dead."

"Oh that's just the Goth look," I would say. "She loves Cher."

I always came to Lola's defense, as I was not only her friend but a fan. She once told me, "I don't know what I'm turning into."

"I know what you're turning into," I said with a knowing smile.

"What?"

"A gay man. It happens to every good nurse."

With that she laughed so loud it almost made me believe she was normal, but I knew there was a razor slicing her from the inside-out. I had been in love, I knew the wear and tear.

One Halloween, Lola dressed up as a pirate and decorated a stretcher like a ship.

"Wheel me into the cafeteria," she exclaimed. "I want to make a grand entrance for the costume contest!"

I did as she asked and pushed the stretcher like a sail boat. She stood up holding tight to an IV pole yelling, "Aye aye, maties!!!"

We expected laughter, but instead we could hear the sound of dentures chomping on pork tenderloin. We missed the mark. The contest was held in the lobby not in the dining room.

Once again the Head Nurse was livid.

"What's wrong with Lola?" she asked rhetorically.

No one knew, but I spotted that deep, bleak sadness the moment I saw her.

Her husband had died tragically in a car accident 6 months before she moved to San Francisco. She had demanded that he pick her up from work even though the roads were covered in ice and sleet.

"I can't cry," she told me. "If I do, I'll never stop. He's the half of me I can't shake."

Once she played her dead husband's tuba for the nursing staff at a bridal shower. It made a bellowing noise that filled the dining room with a drowned-out sorrow, but I seemed to be the only one who understood the musical lament. Everyone clapped and cheered. "Again!" they hollered.

When I asked her the name of the song, she laughed and said, "I made it up. These people are clueless." Perhaps she was right.

The last day I worked with Lola was a day I'll never forget.

She called me into an empty patient's room, sat down, and held an open box of gloves on her lap.

"Lola, what's wrong?" I asked pointedly.

"I'm severely allergic to latex," she replied.

Then, with the heaviest heart, she told me, "Please don't tell anyone what I'm about to do. I just can't work as a nurse any longer."

She then lifted the box of latex gloves and inhaled it as if she was breathing in a dozen roses. When nothing happened, she did it again. This time I could hear the whispers and crackles of a torn life within the sounds of broken breath.

She started wheezing and I realized what she was doing. This was Lola's boo-hoo, she was crying out loud.

I hugged her with loving intensity, quietly saying "there, there." Lola then asked me for advice and I whispered one word in her ear. She nodded yes and then excused herself to the emergency room as graceful as a swan.

I reflected upon our exchange...

"What can kill this pain?" she had asked.

"Dance," I said.

Dance...

One Flew Over the Poo-Poo's Nest

2010-01-09T09:26:00.018-05:00

Recently, I encountered a bitchy woman in the back of the ER who was yelling for a bag lunch.

"Get me the peanut butter or I've got something so dangerous here you won't know what hit you!"

I saw her reach for something under her sheet and I sprinted for the Hospital Police. When we got back, there she stood in the middle of the Holding Area with a weapon so dangerous I almost stopped breathing.

"Stand back!" she screamed. "I'll throw this at you! I swear to God I will!"

She stood there holding her colostomy bag, full of liquid poop, like a professional baseball pitcher.

(A maniac with poo is a nurse's worst nightmare.)

It had a terrible smell and its destination was me.

"Please drop it," I requested with my eyes as big as saucers.

"What do you want, ma'am?" asked the 5ft 3 policeman wearing a bullet-proof vest.

"I said I want the peanut butter!!"

Needless to say, a bag lunch was tossed her way.

Nurses deal with a lot of crap, both professionally and personally.

Too bad a loving man was never tossed Bree's way. I worried for my dear friend after she lost her penis in the Philippines. She became a lost soul and a magnet for second-hand losers in her search for "true" love. What she found was bullshit and it took years for her to recover. This is an RN with a heart of gold, but sometimes that means nothing in the real world.

"Men are full of dookie." Bree had resigned herself to the simple life of Absolute martinis and double shifts.

I wanted to help her create a new world of social acceptance and someone suggested the Internet. Even though we were experienced in our careers we were novices in the new world of online social networking.

(It's weird that I still can't take a photo with my phone but I can take charge of an entire ER.)

I suggested Facebook and after helping her post a profile we began the shakedown for friends. Our friend Christmas Madamba has 46o friends (but this is a girl who answers the door with no pants on). In this "real" world, and under Bree's profile, I looked for groups that might interest her. And in one discussion group, I discovered poo stories.

Why do nurses always need to talk shit?

Strangely enough, I found a story so "LOL" funny I am including it in its original form. A story so simple and yet so poignant about creating your own friendships, it takes "friending" to a whole new level.

*A shout out goes to "Cassie," whoever you are.

"I had a patient in hospital once who made little poo people...with a head, arms and legs. She was talking to them and having morning tea. When I tried to remove her poo people, she cried, saying visiting hours weren't over yet."

Blinded By the White

2010-01-06T12:37:00.067-05:00

The year was 1992. It was the year of the pop song "Baby Got Back" and the year of the Pyxis, the brand new automated dispensing machine for narcotics.

One afternoon, as I was working in a hospital in Pill Hill, “Boots” strolled in, the worst Head Nurse of my entire career. I gave her that nickname because of her trademark shoes…cropped brown boots crinkled at the ankles...ghastly.

That day I attended a potluck hosted by Miss Mae, a ward clerk from the old school of hard knocks, a classic dinosaur. She wore girdles and never talked back. She was originally hired at Pill Hill to scrub and sterilize bedpans.

"Miss Mae," Boots said with a crooked smile. "You people make the best ham."
Then she turned to me and said, "You people wrap the finest gifts. Why…look at this bow!"

Gays and Blacks, I thought to myself. This manager was the queen of cultural profiling.

"Miss Mae bought the ham from Honeybaked and Macy's did the gift wrapping," I answered politely.

"Why…you people are always the sassiest bunch!”

And just as I was about to counter attack, in walked a nurse with hair so yellow that even jaundice couldn’t compete. She reminded me of a downmarket Sandra Dee.

"Hi y'all," she said with a smile so bright it made you believe in sunshine.

"Who the hell is this?" I whispered to Miss Mae who was busy cutting up a pig.

"This is Nurse Traylor," said Boots. "She's a travel nurse from Arkansas."

Just to be nice I complimented the new RN on her bedazzled track suit, and as she stood up to dip a potato chip, we saw the word "Delicious" written across her backside. Yup, Baby had back.

The next day I heard the loud "cla-cla-cla" of the Filipina nurses as they scattered out of the nurse’s station. I love the Filipinas (without them there would be a severe nursing shortage) but when they got excited they sounded like chickens at a flea market.

This time, however, the "cla-cla-cla" meant Boots was coming, and she was on the warpath.

"Two Vicodin are missing!" she yelled directly at me.

Once again with the profiling, I thought.

"The Pyxis will report who took them out," I responded calmly.

"It was under Miss Villanueva’s name," she said. "But she would never steal anything. She's a Catholic!"

About a month later, during the morning report, Nurse Traylor sauntered in, late as usual, and sat down. Without any trace of enthusiasm she said, "Hi y'all."

As I ate my cinnamon roll I heard the distinct growling of Miss Mae passing wind.

"Miss Mae your girdle's too tight! It's restricting movement in your colon," I commented.

"It's not me," she said pointing at Nurse Traylor. I turned quickly toward the sawing sound and there she was in a deep sleep, snoring in the corner of the report room. We had begun to notice that Nurse Traylor had started to withdraw from the group blaming it on some "hard nights."

At the end of the shift that day, 5 morphine injectables were missing from the Pyxis. Boots was beside herself. Fortunately for me, the Morphine 10mg Tubex were taken under Ivan's name. ("Ivan, the terrible nurse" is what we called him.) He was just a forgetful man who had walked away from the Pyxis leaving his code intact.

The "cla-cla-cla" was loud that day. Security was called and everyone had their bags checked, including poor Miss Mae. We watched as seven shades of red lipstick were pulled from her handbag, along with a tube of Preparation H.

"It's for the bags under my eyes," she said apologetically.

The "cla-cla-cla" continued as all the Filipina nurses emptied their purses on the counter, everyone except Nurse Traylor, who had left minutes before the change of shift.

We left humiliated. It was a quiet march out the door, not even a "cla-cla-cla." But we all stopped in our tracks when we heard the shocking words of our Nurse Manager: "Who stole the Morphine?" she asked. Our collective jaws dropped.

The next morning Nurse Traylor arrived for work with her front tooth clearly chipped.

"I fell y'all."

She sat down for report and I noticed it: under her once gleaming hair, now unkempt with black roots, and beneath the smudge of last night’s mascara, lie something so tattered, twisted and in pain not even the Morphine could make it better. It was a broken heart. Her soul was crying.

That same day Nurse Traylor did something so outrageous that it would inspire this story.

It was her last shift, and under her own name, under her very own code marked with her very own fingerprint, from the brand new Pyxis, she stole not one, but 22 Dilaudid (4mg) injectables. (A medication stronger than Morphine.)

It was the day that "Hi, y'all" became "Fuck y'all." And Nurse Traylor was never heard from again.

From that day on, whenever something went wrong, Boots would start by asking the Gays, the Blacks, or anyone from Arkansas.

I Got Your Crazy

2009-12-31T18:07:00.018-05:00

One of my favorite Head Nurses was a woman named Sue.

Sue would go to the restroom on numerous occasions and come back smelling of toothpaste and vomit. I adored her. We all knew she needed to purge the See's Candies she kept in her pink lab coat. After choking down a dozen chocolate morsels in one sitting, what else was a girl to do?

The staff turned a blind eye to this madness because of her grassroots approach to life. She kept things real, even when she counted the candy.

"Didn't you just have a caramel chew?" she would ask.

"Why yes, but you have half the box in your pocket," we would respond.

"I don't eat lunch," she would say as I watched her hand disappear into her confection stash. 4 more and off to the toilet.

Once, she was on a date with a surgeon and he reported to us that she only watched him eat.

"She just sat there and had a glass of water."

Even though the doctor dumped her, we couldn't help but love her. Everyday she came to the unit and clapped her hands saying, "Keep on moving. Don't stop."

I never resisted her philosophy and my legs never stopped walking.

I was a nurse and busy pedestrian, even Fat Pat, who was at least 400 pounds, worked a hallway like a tranny hooker during fleet week.

So, it comes as no surprise that my #1 nursing pet peeve is when RNs are stuck to the chair. "How many horses had to die for that glue?"

"Keep on moving, don't stop" has been my motto since bulimic Sue showed me the way (and I've had knee problems ever since).

To start the New Year, and in honor of the dozen See's Candies, I am purging 11 other outlandish irks that rub me the wrong way. Feel free to take notes...there will be a quiz...

2) Women, please start wearing a sign that says, "I am acting like a Bi-polar mess because I have my period." Do you know how much easier the life of a male nurse would be?

I have my own mood-swing license, ladies, because I'm gay, end of story.

3) Jeggings (those weird jean leggings), especially on MDs while at work. How can a nurse show respect when the doctor has no pants on?

4) Patients who stand outside the exam room in an ER. Stop giving me the evil eye, this is an emergency room and not a bus stop. The name of the game is "hurry up and wait."

5) Du-rags on any employee. Oh yes, and sunglasses during the day while on the job is a bit sketchy.

6) Calling for a personal day and leaving the nurses short staffed when your teenager needs attention. Just call in sick.

7) Coming to work with dizziness because of a hangover that requires rest on a gurney. Once again, call in sick.

8) Asking for a cat-scan while on duty. I am tired of triaging employees who come to the ER. There's nothing like seeing your nurse's aid lying on a gurney drinking gastrografin. (Heart attacks and strokes are welcome.)

9) Not taking my damn report! If you are a floor nurse take the report please. It's not for my sake, the patients need to sleep in a bed and not a stretcher. I am tired of hearing, "We are busy." So are the ER nurses, and for god's sake answer the phone. I don't want to fill out a missing persons report.

10) Triaging a patient who brings in 3 suitcases with the complaint of chest pain.

11) Ambulance crew bringing non-emergent cases. Rash, arm pain, backache, issues of the penis and, my personal favorite, the itchy vadge.

And as for Head Nurse Sue, she was hospitalized on New Year's Day with dehydration. She was taking care of her parents who were bed-ridden at home and it got the best of her. We watched as she ate breakfast alone in the room across from the nurse's station; toast, scrambled eggs and coffee washed down with chocolate Ensure. At this we all gasped.

And then, without any shame and true to her grassroots style, she ambulated down the hallway with her IV pole and pink panda pajamas to her office to make the schedule.

I smiled and said to her, "keep on moving, don't stop" and then started clapping. In fact, we all applauded and gave our Head Nurse a standing ovation.

Then, with a wry grin, she mouthed,

"Happy New Year."

Sometimes an Angel Gives His Wings

2009-12-23T17:17:00.013-05:00

"The heart is the seat of all consciousness." -- Chinese saying

After my first bout of love and heartbreak as a young adult, I once read that "The heart, with all its good intentions, is the boss." I found this to be true not only in my personal life but in my nursing career as well...

David was brought into the ICU in severe respiratory distress, his war with HIV was coming to the final assault. He had a long-term partner who was sick in the Oncology Ward and they were forced to spend Christmas Eve apart and in the hospital.

David needed to be intubated and, after giving him some morphine for comfort, he pushed an envelope into my hand with his partner's name on it. I assumed it was a Christmas card and put it on his bedside table. It wasn't long before the humming of the respirator became the breath and vein of his life's blood.

After settling him in with deep suctioning, clean sheets and a morphine drip, we could hear the distant, peaceful drone of the volunteer Christmas carolers singing "All is Calm." I was grateful that my patient was neat and presentable and, as they surrounded him, was hoping he could distinguish this holiday catharsis from the cacophonous alarms of the ICU.

I was doing my charting when another nurse brought Walter to the bedside of my patient. They had been together for over 10 years and would die together as young men.

Walter told me he wanted to give his partner a Christmas present. "We're living on social security," he said. "And this is all I can give him."

He pulled a newspaper clipping of a large white stove from his gown pocket. "David loved to cook," his eyes shining like stars. "We could never afford a nice stove for our studio apartment. All we have is a hot plate, but tonight he'll get his wish."

He placed the Sunday advertisement of the Home Depot stove on David's chest and then held his hand. He asked for a washcloth to wipe the fever from his brow and proceeded to talk to him.

"David, it's Christmas. With this stove you can bake us a pumpkin pie that will fill our apartment with the smell of home. Just for tonight we're not sick. Can you hear me? Tonight we won't go hungry."

My eyes were thick with water as I witnessed their hell on Earth. I then gave Walter the card his lover had given me. "This is for you."

"My eyes are bad from my disease," Walter said. "Could you read it to me?"

"Of course."

I described to him the beautiful picture of angels wings on the card and then read the short note.

"If I die before you, I'll take these wings and promise to find Heaven for us."

Then we all fell silent.

The heart is the boss, I thought.

David's heart, despite all that heavy sedation, had remained conscious and in control.

Trauma Queen

2009-12-17T16:49:00.040-05:00

Not so long ago, I found myself on my hands and knees. My family gathered around a recent snapshot of my mother and we prayed to a pair of her shiny gold-lamé slippers on the homemade altar.

"This is what she will wear on her journey," my sister said after smoking a joint in the kitchen.

I knew those slippers very well as I had bought them at Sears for five dollars.

Once, when paramedics called my house to tell me that my mother was about to jump off the roof of her building, I nonchalantly replied, "It's only a two-story building." Shocked, they quickly passed the phone to my mother.

"Mom, stop that bullshit. If you jump you'll only fracture your ankles and you won't be able to wear those lovely slippers I gave you!"

She never jumped, but she loved having an audience. The closest she had gotten to death (not of her own making) was when a bullet sailed through her windshield.

"Your father wants to kill me," she said while adding another sequined butterfly to her geisha-beehive hairstyle.

"No he doesn't. He only wants to scare you."

I remember staring strangely at her hair when a fashion suggestion suddenly came to me, "Mom, you should wear bangs."

"Bangs are for amateurs," she snapped. "I wouldn't be caught dead in bangs."

After a lifetime of tragedy it was ironic that my mother died of an aneurysm. She had a headache, ate a hot dog, swallowed some Tylenol, and poof!, she was gone. They found her reaching for her panic button, the same button she used to raise the stage curtain in her own plays and taunt the emergency medical service.

At her funeral, the backdrop of her last act, I remember sitting in a pew afraid to view her body.

As a nurse I had wrapped at least 100 dead bodies, but I couldn't muster up the courage to look at my own mother lying in her coffin. The smell of formaldehyde filled the church and made my body rigid with trepidation.

After my sister smoked a joint in the parking lot, she joined me in the front pew and together we watched as ten strangers entered the church. They had all gotten out of a van and shuffled silently in the back.

"They look like Zombies," I said.

"Oh, they're always like that. Those are mom's friends from the mental health program."

"They must be loaded up on Abilify and Zoloft," I whispered.

Then, after a long silence, my sister began to speak. I was waiting for some words of comfort when she reached out to me and said, "Do you think that mom has any panties on?"

"What?!"

"The mortician. Do you think he put her panties on? I bought a fresh pair for her to wear on her journey."

"This must be some journey," I said. "At least she's not walking barefoot."

When my sister suggested that she might "take a little peek" to check for the cotton drawers, I knew then and there that marijuana is never a good idea at a funeral.

It was then that the Zombies lined up at my mother's side...one by one saying their good-byes.

I knew it would be my turn next.

My sister promised me that my father would stand by my side to hold me up should I make a dramatic attempt at fainting.

"No, I'll be fine." I assured her.

I knew that our brother would probably throw himself in the grave and I didn't want to steal his thunder.

When I reached the purple-felt box that would be her final bed, my father got up to join me. In fact, the rest of my brothers and sisters stood up to assemble a family farewell.

I saw her arms resting comfortably upon a stockpile of photographs, my graduation picture sitting prominently on her belly. The ivory gown laced with french roses and the rosary wrapped around her wrist were a vision of death couture.

I was pleased and started to make peace with this parting scene. As my eyes turned to see her face, I was overwhelmed with a sense of despair that made my knees buckle. I was about to drop to the ground when my father took hold of me.

"Is it too much for you?" he asked.

"Yes! Oh god, oh god!!" I waved my hands in the air like the last disco dancer. My cries were loud enough that even the Zombies stopped drooling and started to perk up on the sacred benches.

I clutched my Versace tie when my sister with the bloodshot eyes asked, "What is it? What do you see? Do you see her blessed spirit?"

I swiveled my head 'no' as the flood gate of tears opened from under my expensive RayBans.

And then, without any hesitation, I yelled as loud as I could:

"Bangs, I see bangs!!!"

Scar Wars

2009-12-07T13:55:00.046-05:00

It began with something that went bump in the night. I awoke to my mother's frightening tale.

"There's a prowler at the window," she whispered.

"The bogeyman?" I asked wiping sleep from my eyes.

"Of course not, the bogeyman isn't real. This is a prowler."

She hurried me out of bed to the bathroom window where her mad vision had taken place.

"What's a prowler?" I asked.

"You don't need to know! I just want you to go outside and make sure it's not there."

"But I'm only 5 years old," I cried.

"Stop that whining. The prowler doesn't want you, it wants me. Now go outside and scare it away!"

"What about dad?"

"He's out bowling and he has three frames left," she said matter-of-factly.

When I came back into the house that dark night I crept past my mother who had fallen asleep on the sofa.

"Did you look under the bushes?" she asked scaring the hell out of me.

"Yes. There's nothing out there."

Then with just a hint of endearment she said, "You are, and always will be, a survivor."

Years later I realized that my mother had truth in her shadows. She was right, the prowler did want her. The abyss of her mental deterioration had just begun to emerge and the voices were starting to take residence in her saddened nut house.

When I was 17, her new husband once woke me up with a knife at my throat. He was an abusive drunken mess. The next day I said, "Mom ask him to leave."

"Why should I?" she said. "You don't even have a scrape on you. What about me?" she continued. "My head is a bloody mess from that frying pan, and I just had a wash and set."

Then she repeated her famous words.

"You'll be fine, you're a survivor."

She was absolutely right about that as well. I knew I needed a job to leave her tiny apartment so I applied to a beauty school. I had waited for my mother a thousand times in beauty parlors and observed my fair share of teased-up hair-dos...so why not?

I missed the stylist deadline, but a kind counselor offered me a Ronald Reagan nursing scholarship. It was how I came to be an LPN at 19 years old.

I have survived a long career that has included med-surg, Oncology, ICU and ER. I also furthered my education at a nursing school in the Big City. It's unofficially called a "boot camp" for vocational nurses.

Some of the women at that college were scarier than snakes slithering under a door, but many of the best RNs are spawned from being an LPN, and I am proud of that. Like my mother said, I'm a survivor, even if my life's pursuit began at the end of a jagged edge.

I am that powerful "something" that was forged from my mother's schizophrenia. She taught me pride, humility and, most importantly, she taught me courage.

Every time I triage a psychiatric patient, I know the strength it takes to witness the breakdown of the human soul. There lives a tragedy behind every insane, neurotic triage complaint.

If you look close enough you can even find a melody behind every malady.

I started this blog filled with a sanctuary of reservations: Would I be misunderstood? Could my flashbacks serve as a sort of "rah-rah" that might encourage and welcome nursing newcomers?

Followers to this blog have come from Australia, New York, California and even the Philippines. They are young, old, male, female, gay and straight, but with a common interest...to read my little stories. And I am very thankful for that.

Sometimes I provoke inspiration and, then again, you might read a flare-up of pee, poo and wigs flipped backwards.

My storytelling has been sprinkled with an extremely creative imagination (hey, it's my party and I'll lie if I want to).

But this is what I know to be real: I am a middle-aged gay man who is grateful for a long and illustrious career, and I live with an open-hearted honesty.

I know the dull, aching pain of Love's heartbreak. I've known nurses who have committed suicide and nurses who were drug addicted. I even watched as one nurse ran off the floor to spend some time crying in the rain. She was overwhelmed with the grievous chore of her first shroud.

I've had great nurse managers and some extremely awful ones.

And through it all I carry one certain and undeniable truth: Nursing has been good to me, and I to it.

I am a survivor.

I am a Registered Nurse.

UNBEWEAVEABLE!

2009-12-02T14:45:00.043-05:00

"I'm so tired of fighting with my patients. Just put weights on my legs, drop me in the Hudson River, and see if I float." -- quote from an RN in NYC.

On my first day of work in NYC, I sat in the lounge for my lunch break. There was an ambiance here that I had never experienced.

It was 1 pm and I was surrounded by housekeepers blasting a Spanish soap opera on a small television set while the "aroma" of microwaved fish consumed the atmosphere. An RN was snoring in an old geriatric chair and an ER tech was brushing her teeth rather loudly at the sink.

There was rubbish everywhere and all I could think was, "Oh my god, what did I sign up for?"

The bathroom door opened directly onto the eating area and introduced a pungent odor. Nobody flinched. Not a single word or scowl. No one made a sound, not even a mouse...or so I thought.

I was fresh from California, eating a salad for lunch and sitting very upright at a small table in the corner. I wanted conversation about film or literature. "Has anyone been to the Angelika Film Center?" I asked, eagerly awaiting the adventure of new friendships.

"What the hell is that?" said Fifi as she ripped the bones out of her roasted chicken.

"It shows art films," I responded. "Or perhaps you've read The Lovely Bones?"

Snap went more chicken wings.

"No one has time for that," she crunched. "All New York RNs have 2 jobs. You California nurses never realize that. The nurses out there have it all backwards."

Before I could digest the entire lounge experience, a small black tail ran by my foot heading towards the coat closet.

"What was that?!" I yelled, almost choking on lettuce.

But before Fifi could answer me, another black mouse scurried across my Nikes.

"Oh there she is," Fifi said. "They've been together a long time."

I never ate in the lounge again.

I thought NYC was going to be paved with lights and dreams as if the cliches had some basis in reality. But hard work and the 2nd job were soon to follow. My easy care-free life in San Francisco was left behind, replaced by subways and SUBWAYs, my surrogate lounge.

RNs in New York eat a hardcore breakfast. No fruit or yogurt, but a large roll filled with sausage and eggs lathered in real butter. The nurse's station cabinets are filled with fake handbags bought off the street. The NYSNA photographs display weathered faces and bargain basement sweaters.

The California Nurses Association photos portray nurses in an extremely different light. Real Gucci handbags with matching shoes and belts abound. Nurses do wine lunches after Botox treatments.

There's polite conversation about culture and politics. California nurses drive nice cars, not the beat-up jalopies. There's a liberal attitude about sex and teeth whitening.

RNs in NYC are the real deal...and the fiercest nurses on the planet. Not only do they disregard cholesterol levels, they are imprinted with a highly suspicious nature. Collection cards are closely guarded.

"We're collecting for the death of Pauline's father, and don't steal anything in that envelope."

And the favorite saying, "Don't fuck with me," can apply to almost any encounter. And I used it freely until I learned a valuable lesson.

Once, Fifi rolled a stretcher carrying a homeless patient soaked in urine and maggots to me, and blithely said, "Here. This is now your patient."

I was courageous enough to say (and after hours of practice in a mirror), "Don't fuck with me, Fifi. This ain't my first time at the rodeo."

"What did you say to me?" the vein in her forehead forming a large V.

"You heard what I said. Don't fuck with me, Fifi!!"

She replied with a coy smile, "Oh, I didn't know you were offering."

Then she said, "I thought your gay self had it backwards."

At this, I scurried away like the mouse in the lounge.

Yup, an RN in NYC is the real deal...

Oh, except for the hair.

One day, Fifi came to work 35 minutes late sporting a very unusual appearance. It wasn't the dangling earrings (shoulder length, of course), the ruby red lipstick, or the tomato red scrubs complete with panty line and camel toe. (NY style, you gotta luv it!)

But her eyes were strange. Fifi's eyes were missing and somehow she made it to work.

"Fifi, what's different about you this morning?"

"Nothing darling."

"My, what no eyes you have."

"The better to not look at you, my dear," she growled.

"No, no. There's something a little off. Your fluffy hair is covering your thick eye brows."

Then without missing a beat, I checked the back of her head and gasped loudly enough for the entire ED to hear me. "Oh my god. I know what's different."

"Fifi, you have bangs on your neck!"

"Don't say a word!" she squeaked, and scampered to the hallway mirror.

And there it was in all its glory, the synthetic feathery mess that sat on Fifi's head had been turned around.

This time it was Fifi who had it "all backwards."

RNs Aren't Built To Break

2009-11-26T11:39:00.026-05:00

Once, I witnessed an RN's final, solemn march.

Many years ago, while working in an ICU in the hills of San Francisco, I sat at the monitors and observed Jerry pushing a very heavy hospital bed across the unit by himself (as you know, nurses often work alone).

His struggle, personified in an extremely thin frame pillaged by AIDS, refused to quit working. He was an ICU Nurse devoted to his career and wanted to pay off his debts before his death.

This nobility couldn't overcome his attacker, however, and he died a week later. His ashes were thrown into the Bay by a handful of nurses who had become his de facto family.

I remember his cool-headed approach to his illness and his mortality.

"RNs aren't built to break," he would say.

He was committed to his work ethic in an environment that encouraged an honest, open approach to illness, even when it was one's own.

I'm writing this story not to embellish sad thoughts or gloomy moralizing, but to simply acknowledge the strenuous endeavors of an epic career filled with good fellowship and camaraderie.

There's a big difference between the West and East Coast and I'm sounding the alarm....ringing the bell and clanging the trolley.

I had been on vacation and upon my return I asked my colleagues, "Where's Grace? I haven't seen her in a while," and was met with a disquieting "SHHHH!"

"Be quiet," I was told.

"What are you talking about?" I persisted. "What's the matter with Grace?"

I put on my mining cap and continued inquiring until I discovered the heartbreaking truth.

"Grace has cancer," Miss Kimodo said. "She's terminal." (Stage 4 breast cancer)

"Grace has too good a heart," I replied stunned and tormented.

She is only 34, a wife and mother, and gifted with perennial cheer. She's a nurse who "has your back."

Have you ever watched a Chinese family working together in a restaurant? It's very much like the excitement of a busy nurse's station. The pots and pans create a busy melody reflecting the hospital-ity of family. And there's always a child in the corner doing her homework.

In my experience, it was Grace finishing her master's degree on any computer she could get her hands on.

Ladies and gentleman of the nursing profession: Cancer is not a horrible secret or something "bad" that happened because of karma. It...just...is.

In the tradition of honor and affection, and in the old-fashioned warmhearted style of nursing, I am reaching out to all those Amazing Graces. The RNs, LPNs and aides that you work with are your second family. Embrace the big picture.

Breast Cancer should not be silenced. If it is, it will shut out all the good intentions of caring comrades. It will also inhibit the funding needed to search for a cure.

Yesterday, I noticed for the first time in years the beautiful sunrise over NYC.

It carried with it all the residual colors of Autumn. And in its golden hue, I reflected on the words of an exquisite nurse:

"RNs aren't built to break."

...patients and doctors should be thankful for that.

Excuse Me. Is the Morphine Fresh?

2009-11-21T10:30:00.004-05:00

Basic requirements for all nursing candidates include:

"good moral character"
full disclosure of criminal convictions
knowing how and when to give the WTF-glance

Yes, the WTF-glance. I also call this the "$8.99 deadpan"...here's why...

Once, while going through airport security, I was stopped by a female agent. My genuine Coach cabin bag was searched and out came a hula-girl lighter that, when lit, flashed its boobs.

The agent pulled it out of the bag and shot me a disconcerting stare. I was surprised to see this novelty gift in my carry-on as I forgot to put it away in my checked luggage.

"Oh no," I lamented. "That cost me $8.99."

She returned my sentiment with a WTF-glance, a knowing glare that I interpreted as 'Are you kidding me? $8.99, who gives a shit?' Then threw the new lighter away.

This is the same deadpan look that I've learned to give many patients, an art form that's difficult to put down in black and white. Only a skilled and literate patient can manage to write it down correctly on a complaint form, otherwise it reads, "The nurse gave me a dirty look."

"I don't recall that look," a wise nurse responds. "What do you mean?"

(I rest my case.)

[Example One]

Latina patient says: "Look into my eye, what you see?"

"I see lots of mascara, eye liner and blue eye shadow," I answer.

"But I have pain in my eye, what else you see?"

"Oh yes, I see the redness from TOO MUCH mascara, liner and blue eye shadow."

The patient presses me further by asking my thoughts and I say, "No one uses blue eye shadow anymore."

She looked quizzically at this helpful beauty advice, so I continue the triage examination with the Snellen Eye Chart.

"I can't read it," she says while covering her well-decorated eye.

"Just read the top letter," I ask.

"No can see," she insists. Then goes right up to the eye chart, puts her face up to the big letter E, and says, "I think I blind."

Huh? I just saw this woman through the plate-glass window not 5 minutes earlier reading the directions to my triage chair.

I have nothing more to say and give the deadpan WTF or $8.99.

"Can I get glasses now?" she requests.

She then gets a double What the Fuck (or a $17.98).

[Example Two]

28 y/o obese female --negative for pregnancy-- comes in with "severe abdominal pain."

This is her 4th visit in one month. She is seen talking and laughing with at least 8 family members who surround her gurney with folding chairs.

ED. physician orders Reglan, Pepsid, IV fluids, Morphine and Gastrographin in one liter of water.

This elicits the first WTF or $8.99-look by this nurse. This kind of "cover your ass" medical service always generates a very deserved once-over.

"Morphine?" I ask. "How refreshing."

"The only thing fresh here is the nurse," the MD says.

(No, I think to myself. Years ago I was told that a fresh dose of Morphine was one that the nurse hasn't licked. Old school joke told by an MD., of course.)

After I administrate the pain medication I hear over the loud speaker, "Your pizza is here."

To my utter amazement, the same patient who just drank one liter of Gastrographin gets out of the stretcher, takes her purse to the main desk, and starts counting out her coins.

She retrieves the pizza, no tip of course, and brings the entire box into the ER telling her family to hold it for her.

I explain to her that she's ready for her abdominal cat scan and she is Nothing by Mouth.

"I know," she tells me. "I want to have the pizza ready for when I get back. I hate those bag lunches you hand out. The turkey sandwich is so dry."

$8.99, I think. $8.99 or a big WTF???

[Example Three]

But my absolute favorite of all time is the patient who is escorted to the exam room and, after a kind "hello" from this nurse, is handed the hospital gown with the basic instructions, "Please put this on. The doctor would like to examine you."

After 15 minutes, I walk into the room and there stood the patient, cool as a cucumber, wearing the gown OVER the clothing...including over the winter coat! It's like wearing your underwear over your clothes! We've all done this but not since we were 4 years old.

Now that was a classic What the Fuck moment.

Any WTF looks ever had to come out of you?

Property Before Airway

2009-11-09T13:05:00.026-05:00

When I worked in San Francisco, the diet of a gay man was a milkshake and an Ex-Lax.

Last night, I laughed about this as I swirled my Cabernet and popped two of those wonderful round tablets.

I'm currently on vacation on the island of Kauai and I am constipated. Saimin noodles and Portuguese Sausage omelets will do that. However, the stifled bowel had started with the stress of the ER and the constant search for a free toilet in our hospital.

"Where's my dildo and I got-sta pee," said the Methadonian while attempting to climb out of her stretcher.

"Your dildo is locked up in the property office," I said to her. "That, and 42 cents."

Just then the social worker Vanessa walked by displaying her smart new shoes.

"Look at my new Gucci loafers."

"I don't care about no damn goo-cheese. I gotta pee!"

"Where is this patient from?" asked Vanessa MSW, as she looked my way.

"Methadonia," I answered.

A "Methadonian" is a patient who visits the methadone clinic on a daily basis and then buys some more on the street for recreational use. They usually end up in the ER as an overdose case. Narcan IV will shake them out of their crisis and back into their culture. (It's the Methadonian way.)

With a Methadonian arrival, ER nurses have a saying, "Property before airway" -- hence the missing dildo.

Christmas Madamba and I were discussing this very fact last week in Honolulu.

"Did you hear what else the Methadonian did that day?" Christmas asked me after ordering her spam and rice.

"The dildo lady?" I said.

"She couldn't wait for the bathroom to open up and pee'd in the wastebasket next to the social worker's desk."

"What did Vanessa say? I bet she was horrified," I chuckled.

"Oh she was! She politely said 'excuse me' to the Methadonian and then moved the wastebasket right out from under her."

"While she was still pee-ing?"

"Yes and the pee dribbled on Vanessa's brand new loafers!"

These are the best of times, I thought. I'm on vacation discussing nursing stories with my colleagues. In Hawaii, it's called " talk-story".

Christmas Madamba met my friend Bree for the first time here on the islands. Christmas bought a stretch dress in Chinatown and treated Hawai'i with this tight-knit vision. A plus-sized tube top and a pair of false eyelashes is her idea of dress up.

Once, in our tight-fitting nurses station, Nurse Vivian yelled at Christmas, "I'm charting here! Get your ass out of my face."

Christmas shot back, "Even better, I just took a shit."

Everyone laughed but I, the gay male nurse, was appalled. "That's a private matter," I said.

Christmas is always open about her bowel habits.

"Bree, last night I had a massive bowel movement. It felt so good, it must have been 12 inches long and coiled around the rim of the toilet," she sighed.

Bree laughed and said, "I have a twelve-inch dildo, it's purple. It was a birthday gift. I love my purple."

It's all about our property... owning our work.. owning our way of life. Not only the physical property but the emotional property that contains our heart and its good intentions.

Caring colleagues, stress free vacations, and the time to clear our own "airway."
Inhale and take a deep breath.

Being a nurse gives us a totally different perspective on life.

Kathy Griffin once said, "I'm owning it and I'm going straight to hell. I've got my hand basket all decorated."

Nurses learn to appreciate the little things as well as the big things. Seeing human suffering on a daily basis will do that.

A Nurse's Manifesto

2009-11-01T07:59:00.019-05:00

I'm stepping up to the plate and out of the box.

I'm a real Nurse: Not the kind of nurse who's stuck to the seat with Elmer's glue, or the clipboard nurse in a starched lab coat looking for errors, or even the nurse who is perpetually late.

I am not an rn (resting nurse).

I'm a Warlord Nurse, marinating in overtime, who fights for integrity and compassionate care.

Recently, I announced over the ER intercom that I needed the attention of a nurse's aide, "Could a competent nurse's aide please report to the station?"

There was work to be done and I needed help. And you know what? No one came forth.

Later that day, a supervisor came to the triage area and stood over my shoulder to reprimand me. Instead of having him look down at me, I offered him a seat.

"Talk to me as a man," I said. "More importantly, talk to me as one RN to another."

"Did you announce that you needed a competent nurse's aide?" he asked.

"Yes I did."

"Why did you do that?'

"Because it's what I wanted. Because it's what I needed. Competency is what we all want, especially our patients."

He was stern in his efforts to counsel me, and then he asked, "What if I went on the loud speaker and asked for a competent RN?"

Without hesitancy, I replied, "I would step up to the plate."

(I hold my pee, my glasses are lopsided and frame puffy, tired eyes, but I keep moving, and my co-workers never have to look for me.)

Regarding lazy nurses and aides: A wise Nurse Chen once told me, "A crow is black all over the world."

Then she would go into the pantry and eat bitter melon, (raw).

Nurse Chen was hard-core, but she was hard-working and never suffered from indigestion (nor indignation).

I eat bitter melon of a different kind.

Every time I suffer the indignation of a physician who yells at me, I swallow...

Every time a nurse's aide rolls their eyes when I ask for simple vital signs, I swallow...

Every time a nurse hangs up on me when I'm trying to give report, I swallow...

I protect and serve. I am a health care soldier.

I belong to the division called N.U.R.S.E.

Necessary
Unsung hero
Resilient
Selfless
Essential

It begins with us...and ends with us. We take all the bitter melons and make melonade.

I am stepping up. And I am demanding respect.

I'm a real N.U.R.S.E.

Can I get an Amen?

What Can Brown Do for You?

2009-10-28T07:49:00.010-04:00

"A man can go seventy years without a piece of ass, but he can die within a week without a bowel movement." -- Charles Bukowski

Patients look to nurses for many things: They look for strength, they look for guidance and, most of all, they look for integrity in the face of their trampled humility. Sometimes the best advice to give a patient is "hold on tight."

The tale of Lorna begins with a pamper.

"Lorna, I suggest you wear a diaper today."

"Of course not, I'm a lady," she sniffed. "Hand me my Hanky Panky lace panties. My sister bought them for me at Neiman Marcus. I was their #1 model many years back, you know."

Lorna had related her modeling stories and the adventures of her love life numerous times. I pampered her by lending an ear.

"Did I tell you the story of Henry?" she once asked, crunching her dentures on an egg roll. "He was in the mafia, you know. He would fly me to Las Vegas and we would stay at the Flamingo. I was his #1 girl."

She would always drift back into her past in an attempt to momentarily forget her present. She loved telling her "#1" stories.

Lorna was in her seventies with a tumor the size of a baseball on the right side of her neck. Sometimes she would wear a silk scarf to cover the crusty radiation lesions that dotted the monumental growth, but more often than not she would leave the snappy neck piece in her room.

(You know you're a nurse when you can stand and stare into the face of cancer's horror show.)

"I still think you should wear a diaper, Lorna," I repeated. "You've been drinking a lot of prune juice with your Senokot."

"The chemotherapy can be so constipating," she said.

"Yes, doo-doo stuck is a terrible thing for a lady," I said as we took a walk down the long hallway.

Taking the time to walk our patients is like giving a thousand hugs. By offering these small gestures we learn that life is never what it seems. "I've got to hold on tight," she would say.

During these walks Lorna shared her dreams with me. Many included the brutal honesty of fate: "I just want another day."

"Or maybe just a bowel movement," I said softening this moment.

Just then, we heard a commotion in the room nearest to the nurse's station. "What's going on in that room?" asked Lorna as she scurried closer. (Lorna was a curious woman, I called her the kitten with a quip.)

"Let me have a look, would you?"

"No, Lorna." I said calmly.

"Oh pleeeease," she meowed.

"Lorna, that patient is withdrawing from drugs and he's been known to finger paint in there. (For those uninitiated, consider yourself fortunate: finger painting is a term nurses use to describe the drawings of excrement done by disoriented artists.)

"I love art!" she said. And before I could hold her back, she raced her IV pole right smack into the drug addicts room.

Both patients took one look at each other and screamed; he, for the cancerous tissue around her neck, and she, for the ball of bowel movement that came slinging towards her. It hit the wall missing her about an inch from the tumor.

Due to the absolute fright, Lorna could no longer "hold on tight."

And after all the number ones in her life, right there, smack dab in her brand new Hanky Pankys...

Ms. Lorna had a #2.

Bree Lost Her Penis in the Philippines

2009-10-24T07:44:00.020-04:00

Yup, Bree lost her penis in the Philippines.

Well, she didn't actually lose it, the surgeon cut it up and turned it into a clitoris.

When she came back home, she proudly displayed her maidenhead to Timothy, a gay male nurse, who turned so pale that he asked for oxygen. "I can't breathe," he croaked. "It's a purple mess!"

"Bree luuuves her purple," I said. "The surgery is still fresh and Bree's healing, Tim. Serves you right for looking at it."

Bree was an RN who gambled on change. Not only on her own transsexual change but also on the kind people drop into slot machines.

"I was born a woman in a small town called Four Corners." That was her truth and she was sticking to it.

Once, on a whim, Bree and I went to a nursing convention in Reno, Nevada. As all Registered Nurses know, these conventions are filled with loose flowing caftans, Styrofoam cups, watery egg buffets and "happy hours" loaded with taquitos and discount margaritas.

Oh, and there's always that one RN who knows it all, "Been there, done that. Yawn." She's the nurse that has third helpings and answers all the questions in the seminar...even before they're asked.

In Reno this "savvy" nurse sat near Bree during Wound Assessment class. While we were discussing the purple mess of pus and drainage, Bree couldn't contain her own lesion of disgust. "I can't stand that woman next to me," she whispered sipping on a Diet Coke. "Look at her, she's a cow with a mustache. She must be a size 26."

(If there was one thing Bree couldn't tolerate was a woman who looked like a man.)

Bree had her own open wounds to contend with. She was a size 20 and looked like Mrs. Doubtfire. It would have been unkind to point this out to her so instead I focused on her new found foe's upper lip.

"I think she has Hirsutism, excessive hair growth," and then I suggested a shopping adventure. "Who needs this class when you can be in Lane Bryant, it's what real women wear."

While in the store, Bree was holding up a purple sweater in the mirror that was guaranteed to aggravate Psoriasis.

"Why don't you try this lovely ivory ensemble?" I said, spreading it out over two shelves. "Look how the giant buttons cascade down the neck and shoulders. It even has matching capri stetch pants with an endless elastic waist band!"

"That's ghastly!" Bree said. "Besides, I don't wear beige. I love my purple."

"It's not beige. It's ivory. It'll be light and Bree-zy. Go ahead, take a chance."

Those were the magic words. Bree loved to gamble. After all, we were in Reno, Nevada.

"I'll wear it to Bingo this evening."

Later that night we sat on cafeteria tables and watched a runway of nurses drowning in purple-haze polyester. There's nothing like the sight of RNs at Bingo. I looked around and saw an ocean of glasses and bangs, banging down their colored sponges on B-8, B-2 and I-64.

And then it happened.

I looked at Bree with her thick cover-girl pancake and she seemed to be turning almost Kabuki white. She looked exactly like Timothy did when he took a gander at her brand new vagina. Bree's mouth parted open and her eyes were about to roll back. She was utterly speechless and there wasn't an oxygen tank in sight.

I turned around and there she was in all her size 26 glory: It was the woman from the seminar sitting directly across from Bree, only one table away. And there, underneath her Tom Selleck mustache, was the EXACT same ivory outfit from Lane Bryant, complete with the matching river of buttons.

But before Bree could say anything, I yelled as loud as I could.

"Bingo!"

I had just covered all 4 corners.

Running with Stethoscope

2009-10-22T13:32:00.051-04:00

All nurses have a story. The story that hurts.
A story so personal that its effects linger with you even longer than the smell of formaldehyde seeping through a mother's cheap purple coffin.

I was half-asleep when the image of a small poltergeist moved past my bedside saying to my mother, "rectal sex hurts." I quickly realized that it was my mother's 4 foot 6 inch girlfriend Lady-Anne.

I was a teenager living in a studio with my mother and baby sister. We were poor and my mother made ends meet by working as a cocktail waitress in ghetto-town.

"Mom, that's gross," I said. "Tell Lady-Anne to keep her voice down."

"Lady-Anne is telling me about her wonderful evening."

"Ewwww," I groaned back. Then I heard the clicking of two gulp-size Colt 45's.

"You'll find out soon enough," my mom said. "You can't live your life with restraints."

Before the shadows spoke to her, my mother had two real-life friends. One was Lady-Anne.

Lady loved to take Sears portraits of herself and show the 8 x 10 glossies to everyone around. Did I mention she was about 60 and had no teeth?

"Look at me!"

I looked and there sat a gaping black grin where teeth should be.

"The photographer barely charged me for this."

He probably was in shock, I thought.

A few years later I remember telling my mother, "Lady-Anne is weird and I don't want her coming to my nursing graduation."

"What's so weird about her?"

"She wears cheap Woolworth muu-muus and rubber slippers," I protested. "She chain smokes and spits at the same time and she smells like a whiskey sour."

Lady-Anne was no lady.

My mom never showed up for my graduation. It had already begun.

"The shadow told me not to come."

"Mom, stop that bullshit," I said through my teeth. "There's no such thing."

Mental illness eluded me then. I had gone through nursing school on a full scholarship and I was a young, openly gay male starting a life-long career. I was moving into my own apartment leaving behind my mothers bad cooking and canned salmon. No large cotton panties hanging in the shower or even on the window sill. And no more witnessing her daily bruises. "He can't help it," she would say.

I had survived the worst, or so I thought. Little did I know I would soon venture into helpland.

"Help me, help me" is a common mantra in the hospital. You can't escape it.

"Help!"

"What's the matter?"

"I can't reach the telephone."

"Help!"

"What happened?"

"Change the channel, that bitch is cooking again!"

Then one day, as I went running with stethoscope, I heard the "help me" that would cut deep into my memory.

That voice sounds so familiar, I thought.

I was working in an ER when it started again, "Oh please, help me." I went to one of the psychiatric rooms and there she was in a disheveled beehive and smeared eye liner. Lying on a stretcher tied up in a 4-points cloth binding was my mother.

She stared at me and I could both see and feel the ties that bind.

There she was, so helpless and beyond repair...the same woman who gave me her cocktail tip change so I wouldn't have to use the free-lunch vouchers in high school.

"Mom," I said. "Now who's living her life in restraints?"

And for some strange reason I thought of Lady-Anne and her black hole of a happy grimace. Underneath the silence of her gums she found the strength and courage it took to smile in the face of "Cheese!" To sit on a Sears stool and say "Fuck it world! This is me."

And in a weird way, as I envisioned the snapshot of toasting beer cans and larger than life portraits, I snapped back to reality to the sound of my mother's voice, uncharacteristically soft and laced with surrender, "release me."

And I thought the exact same thing.

Release me.

Lettie go

2009-10-18T09:04:00.012-04:00

"Can you take my pussy?" Lettie asked me before taking morning report.

"She's old but she's clean."

"Lettie, why are you talking so nasty before I've had my coffee?"

"My cat, you fool. I need someone to adopt her." At this, the RNs on early rounds had a good laugh.

No one saw it coming.

All nurses know a 'Lettie'. She's the nurse who growls all day and everyone still loves her. She's the cat scratching at your door.

"Lettie, your patient wants her pain medication."

"So what."

"Lettie, 708 needs ice water and a straw."

"Are your hands broken?"

Yes, we all know the type. The nurse we fear and cherish at the same time.

Lettie was the security guard at the celebration pot lucks.
"What did you bring?" The inventory would start at day break and you'd better have something good. Potato chips, cheese and crackers just wouldn't cut it.

"Whats the matter with you? Who cares about that crap when we have ham and potato salad."

Lettie would glow with pride as she watched the Korean nurses bring Kalbi beef and the Filipinas plop their poncit noodles on the white bed sheet masquerading as a table cloth.

She would stand at the door at noon and charge every intern, housekeeper or hospital escort $5.00 who would try to sneak in for a nibble.

"Oh hell-no!" she would bark. "Nobody eats for free. Give me money and give Linda a kiss on her birthday."

We loved our pot lucks with Lettie. "No damn cheapskates," was her motto.

The day before the tragedy, I saw Lettie at the Christmas Ball displaying her mighty cleavage for everyone who had a disposable camera. She seemed happy enough. She was taking classes, working overtime, and had finally given away her prized pussy. At the end of the night she said goodbye to everyone. I remember it well. "Goodbye," she said. "Goodbye."

She didn't show up for work.

"It's not like her to be a no-show." The Nurse Manager had tried calling her all morning. The paramedics found Lettie on her bedroom floor still in her party dress; an empty insulin bottle on the table. She wasn't diabetic, just a middle-aged nurse struggling with her well-kept sadness.

No one knew Lettie would be letting go.

Lettie was a hard-working RN and a binding thread to our nursing fabric. She brushed patient's dentures before breakfast, cleaned under their fingernails, changed the linen top to bottom. She treated nurses aides to coffee and gave rides to anyone working a double shift with her.

We all know a 'Lettie'. And we've all lost one, too.

Muffins aren't just for breakfast

2009-10-14T22:30:00.019-04:00

The muffin top has established itself as Emergency Room couture. Clerks in NYC love, love, love the muffin top. According to Wikipedia: A "Muffin-top" is a slang term used to describe the phenomenon of overhanging flesh when it spills over the waistline of pants or skirt in a manner that resembles the top of a muffin spilling over its paper casing.

I was woefully ignorant of this fashion statement when I asked the meanest clerk of all, "My dear, when is the baby due?"

"Tell me, you did not just say that!" I could tell I got her cornrows all in a twist. "Oh no he did-ent," she added.

It was at that moment that I realized that all the leggings I saw meticulously tucked into boots (without the pants) were meant to be fashionable. The elegance of the Bronx and the crown jewel of Brooklyn personified.

My friend Christmas Madamba, a new and exuberant RN, came to save me from the army of wigs that started to confront me. The clerks had begun to encircle me.

"Come here and let me show you my new black dress from Marshall's," said Christmas. She then tried on her dress in the back of the trauma room and when she came out, I stood in shock.

"What size is that?" the words seemed to spill out of me.

"It's a size 10," she said as she spun around.

"But you're a size 16?" I said as I emptied a disposable urinal into the sink.

"I know, isn't it fabulous?"

Christmas was a free spirit but highly inappropriate.

(She once asked another RN, "Auntie Mae, have you ever had cunnilingus?" Poor Mae, she dashed out of the station almost choking on her Dunkin Donut.)

As Christmas Madamba stood there smiling at me in her stretch-limo jersey knit, it dawned on me...I don't think I fit in here.

Christmas was about to change back into her scrubs when she proceeded to tell me about the massage she received from a man with a pony tail.

"He reached in under my panties to massage my buttocks."

"Under your size 16 Lane Bryant's?" I asked.

"No, silly. My size 8 JC Penney's!"

And with that she skipped away without a plus-sized care in the world.

It was then that I realized that sometimes in order to fit in, you actually have to make things fit you.

Hawai'i-5-oh my god...

2009-10-12T09:38:00.033-04:00

Once...I walked down the hospital corridor with a trail of toilet paper spotted with kaka taped to my shoe. It was Halloween, of course, and the kaka was just the smearing of an old Hershey Bar.

While the other nurses wore little mouse ears and big cat whiskers, I was proud of my costume: it was simple and unique. It was my first year of nursing and I was young, skinny and hot. I was a male nurse with a fierce Farrah Fawcett flip and a moustache. I could work a blow-dryer past its prime.

"Dat look stupid," said the Head Nurse following behind me. "Bettah not be real kine toilet paypah." Did I mention it was Hawai'i in the late 70s? Head Nurses didn't have master's degrees and they spoke just like the rest of us, improper and to the point. (all accents intact)

"Why?," I said. "Fat Hannah is dressed like Lil' Bo Peep," 'now that looks stupid,' I thought. Head Nurse say, "Fat Hannah have tie-roid issue." I failed to connect Hannah's thyroid problem with her need to dress as a very large nursery rhyme, but I say nothing.

Then Head Nurse say, "Toilet paypah not good costume, you so immachoore for dis-kine of job." Then she hit me where it really hurt. "Nexx-week you go night shiff, you learn job bettah and you will work hard --for real. Night shiff, no joking-joking." Head Nurse loved to double talk.

Once she made fried chicken and told us,"Here you folks eat, I make-make."

The Head Nurse liked to tell me about my immaturity. If I was 3 minutes late, had scuffs on my white shoes or ate candy at the nurse's station she would say, "You so immma-chooooore," stretching it out so I would make sure to comprehend it. I hated my boss's threat, what did she mean by "I will work hard. For real"?

"I guess this means I can't enter the Halloween contest?," I said.

Working the night shift really messed with my disco plans, but it was on the graveyard that I learned an invaluable lesson:

Mrs Tanaka was 85 and although I didn't know much about her, I knew she had been a wife, mother and a state employee. Most importantly, I knew she was a Do-Not-Rescusitate because I was scared to death of death.

It was 4am and I was making my rounds. "Mrs. Tanaka, you're wide awake?"

"No can sleep," she said. "I make shi-shi." Let me translate, "shi-shi" is urinate in the Hawaiian native language. Even though there is no "P" in healthcare, as you know, there is a lot of pee.

"Alright, I change your diaper now," I said. It was then that she pointed towards the geriatric recliner. "I will sit," she said and I lifted her towards the chair (we didn't have fancy hoyer-lifts then).

"Shall I show you my new dance?," I said to her while she sat in her chair near the window. She nodded yes. I did the pony-tail side to side whip lash that was so popular then. You know the one (the make believe pony-tail that slams from shoulder to shoulder).

Mrs Tanaka grinned and clapped. "Funny man." Again, I'll translate for you (funny man = gay man). It was the 70s.

It was then that I noticed her falling asleep. While returning to the station I had a strange feeling about this patient. Why on earth did she want to recline in a chair at 4am?

When I returned I found her looking more peaceful than I've ever seen a patient look.

It dawned on me that Mrs. Tanaka had passed away. There, in an old, blue geri-chair swaddled in white linen and a fresh diaper, she was dead. No more to be. No more coffee in the morning, no more nurses in bunny ears, no more nothing.

As I looked upon the Honolulu City lights, the reality of it gripped me harder then the sight of Fat Hannah in bloomers with her first prize trophy.

Beyond the glass IV bottles, large hypodermic needles and the clumsy loud Kardex care-plans, I had been a part of someones life. Someone's very important life.

This woman had been a wife and mother and her last image on earth was the sight of my Farrah Doo swinging side to side with "I Love the Nightlife" jingling in my brain.

Oh god, I thought. Oh my god, I am a Nurse. A real card-carrying nurse.

I gently layed her back in her hospital bed, notified the supervisor and it was then I felt it...It wasnt a tear, I was too young and vain for that, it was something much bigger: her last breath felt like my first one. Was this a sign of maturity?

"For real," I thought. For real.

(Did your first experience with death as a nurse affect you in a similar way?)

I'll tan while I can, (sir)...

2009-10-09T19:55:00.015-04:00

My mother once wore a condominium on her head. It was in the early 60's and she decided to wear 3 wigs all layered on top of each other. She threw on a blue dress, eyeliner drawn into her temples, frosted pink lips, and she was on her way to the Marine Corps Ball. Her pale shade of schizophrenia had started to peak out under her mask of Shisheido but she was beautiful in my eyes. I knew I could do the same thing with two towels on my head and some mayonnaise on my cheeks. Before she left for the dance she smiled and said, "These are the small pleasures in my life."

Later in my nursing career I reflected on my mother's sad smile when I met Bessie, the bone lady. She had worked as a prostitute in the Tenderloin District of San Francisco and after a series of bad-luck romances and hard drinking, she ended up with Hep C and bone cancer.

Bessie would always say, "I want to tell you my story in case you find me dead here in this hospital bed." I knew Bessie was just being dramatic because everyday at noon she ordered a double cheeseburger and Reglan, ( just in case she vomited).

Once Bessie called me at the nurse's station to come to her room and what followed was a vision that cemented itself in my memory. It's one of the reasons I stayed in nursing. I walked into her room and there she was sitting in the window sill staring out at Golden Gate Park. She smiled at me the same way my mother did before the tears dripped from under her false lashes.

The afternoon sunlight glowed on Miss Bessies legs that afternoon. There she was, in a white one-piece Catalina bathing suit (Miss Dorothy Dandridge style) and a Diana Ross wig via Love Hangover. She painted on her deepest red lipstick and circles of pink rouge.

I had never seen a patient sunbathing in the hospital. I said, "Miss Bessie what are you doing?" She laughed and said, "I'm ready for my morphine."

"Oh," I said, "I thought you were ready for your close up."

I never laughed so hard with a patient. After her dose of IV morphine, I tucked her into bed for her nap still wearing her one piece. She touched my hand and said, "It's the small pleasures, child, just the small pleasures."

May I have another peesh, please?

2009-10-09T17:15:00.025-04:00

There's nothing like the wrath of an itchy vagina.

A young female from Harlem came into my triage area claiming, "I got my pee here." She was holding the customary paper bag of urine.

"Just have a seat please." I said this while assessing an older male patient wheezing in all lung fields with an oxygen saturation of only 94. (airway issues make this a priority patient)

After a wait of 3o seconds she yells, "What about me? You gonna leave me juss settin' hea?"

"I'm with a patient ma'am, I need to get him into the ER for an asthma treatment, as you can see he is having trouble breathing."

At this time she starts munching on french fries taken from a very fake Gucci.

I say to her, "Are you here with abdominal pain?"

"No, I need to know if I'm pregnant, hurry up and tess dis pee."

At this time I am applying oxygen to my current patient when the young woman bellows- "My vaginer is itchy! Isn't that important?" Gulp goes another crispy fry.

In my head I think, 'aaah, the itchy Vadge.' The Spanish say Pica-Pica (itchy, itchy). I follow up with the classic medical interrogative, "Pee-Pee burning?"

"Si, si!"

What comes next ends this polite banter. The Lady of the Fries screams, "How about I throw THIS PISS in your face?" Now, this is not the way to treat a nurse, so I yell "Officer!"

The ER hospital police step into the area when Miss Itch opens her mouth and yells directly at me, "Faggot!"

The disrespect had crossed the line. In what I believed to be a mild whimper of pride I say-- "Yes...I am gay." I look around the room and repeat,"I am gay! Does anyone have a problem with that?!"

"Not me," the old man gasps, "I just...want...to breathe."

I then realize the verbal abuse I inhaled had turned my whisper into something 50 decibels higher. My priorities as a nurse had been distracted.

I collect myself and using my stethoscope as a scepter, I announce regally to the man, "Now on with the resuscitation."

As I finish my assessment and safely place the old man in the hands of a respiratory therapist, I feel a gentle tap on my shoulder. It's the nurse manager. "We loved your public service announcement," he says. "Does a rainbow flag come with it?"

Aaah, the adventures of a gay male nurse in NYC. The front lines of Pee and Sympathy.

Welcome to Pee and Sympathy

2009-09-22T20:47:00.003-04:00

Welcome to this blog. It may not be pretty, it may not be glamorous, but it will be real.

Feel free to comment! I'd like to hear if you've had similar experiences.