Today’s story we’ll go back a few years to the time when I
worked out west in a state and area that is known for being west of the
Mississippi river, yeah that’s general enough. As promised I will not just tell
the tales of female nurse’s gone crazy but also promise to tell the woes and sorrow
brought to my feet by my fellow techs and other health care types. Today is the
tale of Gerald the male charge nurse.
I had the displeasure of working for Gerald for over two years
at this suburban level whatever hospital. Gerald I will say is a good technical
nurse. He was efficient and smart enough to be effective at the bedside with
patients. As a charge nurse he could move patients and was good at that as
well. Gerald was also loyal to his shift and to his people so much so that
eventually he developed a clique. It was the night shift clique and if you
worked a mid-shift or a day shift then you are damned and felt his prejudice
and disdain regularly that is unless Gerald liked you or were a smoker whom he
hung out with. I worked a combo of mid and day shifts due to school and other
commitments and am a non-smoker so naturally I fell into Gerald’s circle of
disdain. Gerald was snide and cutting with no need to be, often over trivial
things. He could be a real hero with the staff at times because he would prod our
at times very SLOW docs into seeing and moving patients. Full disclosure here
this best describes Gerald:
The nasty habit of smoking is a social gathering and one
smoker cannot go smoking unless they have another to partake in this disgusting
habit. The smokers from the rest of the hospital would come down to the ER and
grab our smokers to go out and puff it up. Gerald and his clique of night shift
smokers would often disappear for 30-45 minutes at a time or more to go smoke
across the street off campus; a few if not several times a night. This often
left us short staffed and at times working over because well they tended to go
smoke at the end of the mids shift. Often you’d be stuck there in the ER until
past midnight if you were an 1100 person. Well past 0200 if you were a 1400
person and not get to leave until close to 0500 if you were a 1500 person. Naturally this caused the bosses to get upset
with the people often forced to stay over because they were getting paid extra
for staying over for no good reason. If
patient loads were light and you could get a actual sit down lunch break and
tell Gerald that you wanted to catch your lunch he’d pull the trick “OK but me
and the night shift techs are gonna smoke first is that ok?” What can you say?
Inevitably they’d take their sweet ass time come back and naturally something
would come up and you get no sit down lunch break. In Gerald’s words when a non
smoking midshift nurse pointed this out he stated “Suffer bitch, you aren’t on
night shift.” Which made his night shift types LOVE him but quickly made the
midshifters HATE him.
This mass exodus of smokers often left one or two techs and
one or two nurses to cover a 40+ bed ER. We would make decisions in his absence
and he would get all pissed off and vengeful when this happened but what ya
gonna do when the ambulances are streaming in with ya know sick patients and
when you had walk ups in triage with strokes and MI’s. Now I see you there over
to the side there waving your hand furiously and you are going to say “well why
did’nt you tell the ER manager?” That’s a GREAT idea and I applaud your plan.
Problem is that we had NO ER manager. The acting one was scared of Gerald as
well because Gerald and most of the night shift nurses were travelers and on
the same page. Gerald would routinely
blackmail the hospital into letting him and his select clique into extending
contracts and if they were upset they would threaten to terminate their contract.
Gerald was an experienced traveling nurse and got him and his clique from the
way it sounded iron clad contracts that left them a clause letting them quit at
a moment’s notice with no penalty. Besides you complain and Gerald found out
you’d find yourself in the worst assignments with the worst patients with no
back up. There was no recourse except to quit but this suburban hospital paid
well and had great shift differentials for night hours and weekends. As a tech
every nickel counts.
I shake my head and laugh at this because it’s so absolutely
absurd. Night shift traveling nurses holding a hospital over a barrel just
because they were familiar with how the hospital works and in particular that
ER. I shit you not there were travelers there who extended for 12-16 months; it
was an insane waste of money. The acting ER manager afraid of terminating
contracts because the entire night shift nursing staff would quit enmasse if
Gerald’s contract was not renewed. To top it off a very rare thing travelers
who were charge nurses at a hospital they contracted at. Gerald knew he had a
good thing going. Because of this atmosphere it routinely made for problems on
other shifts and brought about streaks of laziness and contempt I was often
left scratching my head over. Here is where my crusty veneer began to evolve.
This is where such techs like ghost and shadow tech thrived and excitement tech
came to my frame of reference as well. But those are another story for another day,
in fact this hospital in my career has so many nutty staff stories it will take
many many entries to do them all justice, but I digress.
An actual REAL ER manager came on board eventually. She
looked at the waste of money the travelers were especially on nights, heavens
travelers are a stop gap not people who stay on for YEARS. The ER plainly was
losing its ass in salary to traveling night nurses. I think during one meeting
they told us that with what they were paying they could fully staff another two
shifts for the entire ER and OR. I felt certain Gerald’s days were numbered and
in a sense it was the beginning of the end for Gerald and his smoky reign. Suburban ER manager was slick she showed up
one night with food called all the night shift nurses together and told them
that they would have jobs and sign on bonuses at the end of their contracts if
they elected to stay on at suburban hospital. If they decided to leave then no
hard feelings have a good career. It worked I think close to 100% of the night
travelers stayed. Gerald was assured he could keep his charge position and he
felt he was now cemented into his position in the ED.
Then a great thing happened. Around that time the hospital
finally finished up their cardiac care center where they did stents and
interventional cardiology. If you have ever read “The Rape of EmergencyMedicine” then you’ll very well understand what happens next. Suburban hospital
cut their staffing costs and started to make REAL money with this cardiology center.
With this whiz bang state of the art
cardiology suite and the crack practice of cardiology docs on call for our cardiac
alerts things changed. With the threat of a MI rolling in at any moment it made
Gerald stick closer to his charge station. This threat was ALWAYS there but now
Gerald was on the clock FOR the hospital and ER manager who was not afraid of
him was watching and grooming relief charge nurses. Gerald could not go out to
smoke as often as he needed to off campus. This often made for a very grumpy
Gerald and things got worse for a short time. It all came to a head one night
when a cardiologist did not show up quick enough for Gerald’s liking. Remember dear
reader Gerald could be a real cunt to people who fell into his disfavor.
When there was a STEMI alert of cardiac alert or whatever
fucking code language is used to signal that the cardiologist is coming in and
the cardiac cath lab is firing up then a clock starts. It’s contracted between
the cardiology group and the hospital the times and the hospitals
certifications rest on that. It’s money in the pocket to both the cardiology practice
and the hospital, BIG MONEY. So the
Cardiology doc saunters in right on time according to protocol and is
non-plussed by the 12 lead EKG. He says he’s going take the patient anyway but
is not in too big of a hurry to get over to the cath lab, because it’s going to
take time for staff to show up and for them to get set up for him. The
cardiology doc decides he likes the big titted new nurse who has this patient
and wants to explain the 12 lead to her in detail for just a minute more. She’s
single, he’s “available” it’s a teaching moment let this man be, I’m not gonna
fault him. I package the patient and
dash off to the cath lab with another nurse in tow and don’t think twice.
As this other nurse and I are walking back we both remark
that it’s odd that the cards doc did not walk in right when we were leaving
like they usually do. The cath team was kinda worried about that. In fact they
were calling the ER and paging the doc when we left. We walk into the ER and we hear a screaming
match between Gerald and the Cardiology doc.
Gerald does not like that the cardiology doc is not taking this cardiac
alert a seriously as he would like and feels like he is advocating for the
patient. The cardiology doc is explaining that he has time as his team is
setting up the patient and the patient has probs but it’s not that urgent after
all he is the cardiologist and knows how to read a 12 lead FAR better than the
rest of us. Besides this cardiologist is the guy behind the hospital getting
this fancy new top of the line whiz bang highly publicized money making
cardiology suite. Besides that this very
angry cards doc points out by Gerald making a spectacle of this case, Gerald is
delaying patient care. The cardiology doc assures Gerald that he is not done
with him yet and he better circle his proverbial wagons because he’s coming for
him when he’s done with the patient. The cardiology doc gets everyone’s name that
witnessed this and walks off to do his thing.
I leave between 0200-0500 that morning due to the smoker’s
exodus and don’t think twice. Gerald getting into a slap fight with a doc
during shift is nothing new. Nothing ever happens to the bastard anyways. The next day we notice when night shift comes
in that Gerald is not around and a relief charge nurse is doing the shift briefing.
The entire night shift is staring at their shoes speechless. Gerald WAS on the
schedule but has been scratched out for the next couple of shifts. We get the
skinny via the omnipresent ER rumor mill and sure enough the cardiology doc was
a man of his word. Once the cards doc finished up with his patient he
personally called the hospital CEO at home at before dawn o’clock in the
morning and told his tale of woe with Gerald. I do not know what was said but I
can imagine this cardiologist reminded the hospital CEO that he and his practice
was making the hospital a lot of money now and to remember who made more money
for his hospital, the cardiologist and his cardiology suite or a charge nurse
in an ER?
The ER manager shows up before end of night shift that same
night of the shouting match with her new ER assistant manager with her and a side order of HR execs. Gerald is immediately and publicly stripped of
being a charge nurse and told to come back in three days. Then in three days he
can tenure his resignation or write a letter of apology to the cardiologist and
apologize to the staff for his outburst. In the mean time the ER manager and
her assistant ER manager gets statements from everyone the cardiologist got
names from. Gerald I would have thought would have told then to kiss his ass
and leave. But now Gerald has bought a house (this is during the housing bubble,
uh oh Gerald over paid for a house) and is dating someone serious he’s put down
roots in the community surrounding suburban hospital. Damnit Gerald even has a
personal trainer now! Gerald is in a
tough spot, he says he’s sorry all the way around; it was a sight to see. He is
unceremoniously booted off of night shifts and put on days and is watched VERY
closely because the ER manager was thinking that he would never apologize but she
still needs a reason to fire him or make him quit. Gerald we are told has no
authority now and is on a sort of double secret probation. Gerald is now behind
the 8 ball.
All the ER docs he chided and brow beat tend to make things
tougher on him at every turn. The day shift folks remember his snide comments
and public early morning verbal floggings when people did not snap to quick enough.
He is often found in the worst assignments with the worst patients with no back
up. The midshifters remember the same thing as well and act accordingly. When
he sits down at the nursing station to chart EVERYONE gets up and leaves even
the ward clerks, the house keepers won’t even acknowledge him. Gerald becomes
more humble in the day time hours. Gerald rolls away the stone some and is
allowed to pick up extra shifts at night, his rotten attitude and behavior
begin to return during that time but the face of nights has changed, the new
night charge nurses don’t take his shit because they were midshifters and one
of those charges was told “Suffer bitch, you aren’t on night shift.” She says
the same thing to him when he asks for a smoke break one night. He is marginalized and pushed off to the side.
Which he tries to put a positive spin on it but we can all tell he hates not
being in charge, the people he pissed off get their pound of proverbial flesh
from him. Gerald quit before I left there. There was no great farewell party
for him, he skulked away from not only his new house but his new relationship and
hit the travel circuit again, and he left suburban hospital with nary a notice.
I was told a couple of months ago that Gerald is now a flight nurse in oh let’s
say the state of Montana. But knowing
Gerald he won’t keep that job long, he can’t keep his cunt mouth shut.
So ends the story of the Fall of Gerald. But don’t worry
Gerald and his cronies and other characters from that time and place will
reappear here. Fear not you’ll hear more of the Reign of Gerald.
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