basric | LJIDOL WEEK 5 SEASON 7

I do not like writing or reading first person. I like to know what everyone is thinking and feeling. LJDOL is 90% written in first person. I've learned to adapt and even enjoy. So, I am striking out now and writing my first story in first person.

Next, I accept criticism and try to adapt. So far. I've been ticketed by the punctuation police (I'll never get that, the rules have changed too much since my school days. Ticketed by the Grammar police (I really am trying to keep the tenses the same.) But the last one thought I did not prepare my readers for hospital settings. He was right-thank you. I shall now try. I hope you enjoy.

I worked the oncology floor for a year. I was the Charge Nurse with a reputation of being a fearless, cold-hearted bitch. I had no tolerance for laziness in nurses and many young nurse faced my wrath privately when they treated patients like filing they could do tomorrow. I had a no-nonsense reputation with the Residents. They might not remember any other nurse but they left their rotation knowing my name.

The patients on our floor were those whose chemo could not be given as out-patient, patients who had severe side effects from out-patient chemo, Leukemia patients without immune systems and patients brought in to die. The floor policy encouraged family members to stay with patients. Encouraged them to be involved in their care, such as swabbing their mouths to keep them moist and lip balm.

This night there was a steady flow of work on the floor with admissions, pushing chemo and as charge nurse I had to push IV narcotics for the four LPN's on the floor.

Sitting at the front desk checking charts I watched a fourth year resident stroll through the hallway to the back.

In case you are ever in a medical teaching hospital a tip on residents the length of the coat from a short white jacket for interns to Residents 1st, 2nd, 3rd, 4th year and fellows ending with below the knee white lab coats for Attendings. Attendings are the Gods of the hospital.

Moments later he walked back along the hall and out of the unit. Roughly thirty minutes later he stormed by the desk. At the sound of raised voices had me hurrying down the hall. Doctor Michaels was screaming at the RN, Heather. Berating her and he was not careful with his language.

I lay my hand on his arm and he jerked toward me, face red with rage ready to tear into me for interrupting his tirade.

"We need to move this down to my desk," I purposefully glanced back at the patient's room and the family gathered in the doorway, "NOW."

Enraged he stomped to the front of the unit, Heather followed like a whipped puppy.

"Now," I started before he could explode, "Can you speak in a civil voice and explain yourself."

"EXPLAIN MYSELF!"

"I said civil, there are very sick patients and their families on the floor."

"I was down here thirty minutes ago, nothing to be done and told this excuse of a nurse that and she woke me up thirty minutes later with no change in the patient. I want her written up."

Heather meekly whispered, "Dr. Aspen is the attending and the patient's moaning and suffering horribly."

Dr. Michaels was still furious, "I AM THE ON-CALL DOCTOR. WHAT I SAY IS NOT TO BE QUESTIONED. DON'T BOTHER ME UNTIL THE PATIENT DIES."

He turned ready to stalk away.

"Dr. Michael's? You do realize Dr. Aspen has strict guidelines about the care of her cancer patients and controlling their pain."

He turned backed, stepped into my personal space and in what he assumed was an intimidating voice, "Do NOT call me again. As it is I am going to report you for insubordination."

I took a step back and scribbled on a prescription pad and handed it to him.

"What's this?"

"My name, I don't want you to spell it wrong."

"Bitch."

Red faced he talked to the floor entrance and turned, "You call me again and I'll have you fired."

I walked back to the patient's room, soothed the family and assessed the patient who was semi-conscious and in extreme pain.

Outside Heather gave me a full report. The patient had a primary tumor on her pancreas (extremely painful with mets to her liver and spine.) Her prognosis was terminal. Her heart was failing she wouldn't live to the morning shift. But her pain was horrible and her moans could be heard throughout the hallways.

Heather sighed near tear, "There's nothing to do."

I calmed her and started back to my desk. Two steps, three...I froze. An afterthought, a reconsideration--consequences be damned.

I went back to Heather and pulled up the Attending's phone number from the computer. As I dialed Heather panicked and disconnected the phone. "WHAT are you doing? You can't EVER call an Attending. Its two in the morning. You'll be fired.".

"Heather," I moved her hand from the phone, "Nurses forget how many hospitals are in Nashville and the surrounding area, how many floors they have. How many nursing agencies and travel nursing agencies AND there is a huge nursing shortage.

"Hello, Dr. Aspen, this is Barbra, I'm Charge on 9 South tonight, I'm calling about your patient Mrs. X. She is in severe pain, I held the phone out, "Those moans are hers. I'm thirty feet from her room. The family is present."

Dr Aspen, sleep heavy in her voice but she used that arrogant tone Attendings are so famous for-the suppose to make you tremble voice, "You realize I have a resident covering the floor? I suggest you call him."

"Dr Aspen, Dr Michaels has been to see the patient and refuses to do anything for her pain.

Voice stronger now, "I beg your pardon, he's been to see her and not increased her pain medication."

"Twice. The last time he said he was writing us up for disturbing him twice and if I called again he would have me fired. Call him when she was dead,"

There was a full thirty seconds of silence--that's a long time. "I don't think you have to worry about that. Thank you for calling me, Barbra."

"Do you not want to give me a verbal order?"

"No. My resident will take care of it." Dial tone.

I returned to the front desk and almost was run down by Dr. Michaels who was actually running down the hall, white-faced.

He saw the family and patient, wrote orders for pain management. On his way out he apologized to me.

As for the patient she passed peacefully later in the morning. Her family, though mourning her loss had firsthand knowledge she passed without suffering.

I hope Dr. Michaels during his rotation through the hospital, chose a specialty other than oncology when he returned to Oklahoma at the end of his residency.