Number Sixteen

One morning I had to come into work early to get my annual done, which is a type of health screening. You get your required flu shot, they read your TB test and check your vitals. Then unless your TB comes up funky (if it does you get a chest xray). You get your paper work down to the back office secretary then you are free to go unless you have a shift or training to do that day.

I had neither but I had rushed into the screening and did not have breakfast. I went around the corner restaurant/bar and to my surprise I saw some of my night shift cronies with a cool 3rd year having breakfast and post work drinks. Honestly this is one of the occasional rituals I miss most about working nights. When I went to days I left that behind, as the months and years at my present job went by most of the crew left to be replaced by newer folks I did not know. As always there are a couple of old hands around who show the young 'uns where to get a stiff drink at 8am (0800) after a nerve wracking, mind numbing, nightmare inducing shift.

I was out of place in my normal people clothes sitting beside my scrubbed up co-workers. Once the old hands said that I was a night shift tech from way on back I was greeted warmly and grilled. I got asked one question over and over by the newbies:

What's one tip you would give someone new to the ER at Big Inner City Trauma Hospital? (B.I.T.C.H, I know two letters are switched but work with me here)

My reply? Remember who you serve and don't take it personally.

The who you serve thing I overheard a bright former military 3rd year tell a very rattled 1st year after tough shift a year or so ago. I work at a big public hospital AKA "safety net" hospital. We serve the fringe population most of the time the folks where good private medical insurance is not the norm. It's a teaching hospital as well and with the abuse we receive it's easy to forget that usually these folks are SICK. With a population that lives below the poverty line life can be exceptionally hard decisions have to be made do I eat or do I get my meds or go to the doctor where I can sit for hours and miss a day of making money not getting paid and going further into the hole? I'll also admit there maybe a laziness factor or even a lurking denial about their illness. That kind of thinking inevitably leads to chronic conditions or undiagnosed maladies getting worse and worse sometimes with a not so pleasant outcome for the patient (death).  

Yeah...yeah..yeah what are you getting at you underpaid ass wiper?

My point is that despite your intentions here at BITCH we serve the public and really despite the politics of health care right now most old hands here don't give a nasty ugly rat fuck about insurance or ability to pay. EMTALA is not something we trudge on regularly or wave a dismissive hand at. The money end is important mind you but the folks in finance and billing can worry over that shit. So if you wanna work 6-7 days straight and make OT money great. Just remember that we take care of often truly SICK patients here.

The other is don't take it personally. I remind myself of that one often getting called a racial slur several times a shift and being talked down to by a idiot nurse or a new nurse can try what's left of my soul. Getting snapped at by any resident during a code or a trauma call is par for the course. Often there are unseen pressures that you might not be privy to especially if it's menial horse shit. Why did not I telepathically know that there was an add on lab and not draw a special tube when I started the IV? Then getting threatened with a write up. I always say go ahead and do me but I'm gonna be drawing labs for you in the mean time. I'll cut you some slack once or twice but being an ass to me constantly is often uncalled for. I know when it's right to stand up for myself and I'll take the hits but not for long. There is stress and then there is just being a cunt for the sake of being a cunt.

Patients unless they physically attack me or someone else are usually given the benefit of the doubt. Being outraged over drug seeking behavior or the bipolar who is manic at the moment does little if any good. We deal with people and often we see the worst that society has dredged up from the bottom of the cesspool and unfortunately they will make themselves known. But let's not forget the little old man sitting outside the "big room" who is a veteran of WW2 and saw some truly grizzly shit he's a hard man he killed Japanese marines with his bare hands, crying over his wife of 60 plus years who is having acute stroke symptoms and has never been sick a day in her life. Yes of course he deserves and has even earned your time and kindness but so has the insane hemophiliac paroled convict who rips out hard fought IV's and leaves so he can binge on heroin for the first time in 5 years. I'm sure I am at odds with many people over this kind of thought but it has taken me well over a decade to get to this frame of mind. Because I realized being otherwise is a drain on my overtaxed soul.

It takes time and patience with yourself to learn your limits with patients. Yes I know and have experienced many times over what irks us about certain attention seeking personalities of patients AND coworkers. Although I have had my moments I am proud to say that most of the time I don't take it personally because I know at the end of the shift unless something has horribly gone wrong that I'll go home watch a funny brainless comedy show and wash it all down with a cold beer then shower go to sleep and do it all over again.