I’m so honored that one of my recent blog entries has been chosen for Grand Rounds, hosted this week by Circadiana.

So many links and new blogs to investigate, thanks to Grand Rounds. I must be off to do just that!

Kids these days know way too much about the world, at an inappropriately young age.

Not that it’s better to be blindly naiive, the way I was until my 20’s.

Here’s an example: I didn’t know what a “boner” was until I was 14. I had just moved to Wichita, Kansas from a very small baptist town in Oklahoma. Sex was never, ever talked about. No one had it. (Except cousins; it WAS Oklahoma, after all! Hee!)

I knew it took a man and a woman to have a baby. I didn’t know the engineering behind how that happened. I had some idea that something had to be inserted somewhere. But I didn’t know that something else became hard and grew in size, like it was a Saturday morning cartoon super hero with amazing abilities so it could fight crime! (”Wonder Twin powers — ACTIVATE!”)

I finally learned about boners from a friend during the first week of Catholic high school. A group of us girls were gathered around Terry, fixated and repulsed as she explained what a “boner” was. We almost didn’t believe her. But she spoke with such authority, it had to be true.

I remained naiive (read: stupid) for many many years. In 1989, I was 21 and in an EMT class at college. There were 50 students, 42 of them male. (YESSS! THANK YOU, JESUS!)

But one day during a class lecture, I totally humiliated myself. We were in a big lecture hall, the kind you can joke around in and the teacher wouldn’t hear you. My instructor Craig was in the front of the classroom teaching about emergency response to hemorrhagic shock.

Now Craig had “been there, done that”. He came from the “Mother, Juggs and Speed” days of EMS. He had a story for everything, so of course he had a story for non-traumatic hemorrhagic shock.

Craig told us about a patient who wanted to refuse treatment. He was an alcoholic transient staying in a run-down hotel. Craig said it was lucky he and his partner hung around, because the patient finally agreed to go to the hospital. Little did they know, the patient had a GI bleed just cookin’ away inside him. (That’s where either the esophagus, stomach or the intestines is bleeding. If it’s bleeding a lot, it can be fatal very fast).

So Craig is talking to us (the class) about how he and his partner and the cops got the patient and loaded him into the elevator. And the patient started having “the worst flatulence” on the way down.

I was shocked he was telling us this! He went on and on about how everyone noticed the patient’s flatulence, tried to pretend they didn’t, and how Craig was getting sick because of the flatulence.

I was shocked, but started rolling with laughter. Others thought the story was funny, but I was freaking out! Laughing, saying “oh my God”, everything. Poor Craig, having to be in the elevator with this guy and his blatant flatulence!

Did I mention I thought “flatulence” meant a raging, hard-on BONER? (I think I had “flatulence” confused with “priapism“.)

So 49 students and Craig think they’re partaking in a story about heinous farts. I’m the only one in the room who thinks Craig is bragging about a transient having a hard-on over him.

Some guys around me asked me what my problem was, and when I told them my take on the story, they nicely explained to me what flatulence REALLY meant. When I said, “Oh, I thought it meant boner!” that whole corner of the room started laughing. So, as Craig went on with the story about how the flatulence got worse when the patient was in the ambulance, and about how it was brought about by a condition that caused a loss of blood volume, everyone around me was now picturing the transient dying from hypovolemic shock because all his blood was diverted to his penis. The entire corner of the room was laughing hysterically, and Craig just thought it was because he was a master storyteller, so no harm done.

And that, my friends, is how at the age of 21 I learned the difference between farts and boners.

Epilogue: The story did end with the patient surviving, despite shitting blood and feces all over the back of the ambulance and the paramedics, in case you’re wondering how things turned out. A happy ending.

The way a commenter twisted the meaning of my last post around really fucking pissed me off (see comments).

I think people of latin descent everywhere would all be offended that my stance against violent jail riots caused by a lack of Telemundo time can be twisted and misconstrued as not being sensitive to “multiculturism”. Most hispanic people I know would not consider property destruction and violence over not getting their way with the TV remote a part of their culture.

But it did remind me of a story I posted in a blog a long time ago, in a land far, far away.

Some of you may have been visitors to my old blog and did not read this entry there. So I thought I’d re-post it here, so you could not read it again.

_______________________________________

Patient walks into an ER. Older white man. Hasn’t been able to pee for over two days (that pesky prostate)!

I walk into the room, smiling and friendly, and introduce myself as his nurse. I ask him how he’s feeling.

He says: “What the hell are you supposed to be?”

Taken aback, I say: “What do you mean? I’m an RN.”

He says accusingly: “No, I mean, what RACE are you? Mexican? Indian? Eskimo?”

Me, smiling: “Well, I don’t know sir. Which race do you hate the most? Because THAT’S the race I am!”

Sure shut that bastard up!

In reality, I’m caucasian. I’ve always WANTED to have some sort of ethnic culture, but I’m just a caucasian girl with brown hair, small brown eyes, who sometimes goes tanning too much.

In reality at that time, I was ALSO the woman who would be faced with the difficult task of 1) finding this guy’s penis to begin with (he had “innerpenis” or something; I’d never before seen anything like it), and 2) shoving a catheter up it so he could pee. It was MY call as to what size catheter to use. It was MY call as to whether to use lidocaine (numbing) or not. Really, if I was hispanic or whatever race he thought I was, was it REALLY a good idea for him to start insulting me at that particular moment in time?

I say, if a person is so racist that they come to an ER and start picking and choosing their caregivers based upon the color of their skin (or in my case, fake tan), then THEY ARE NOT SICK ENOUGH TO BE IN THE ER.

I left the ER back in the late 90’s. One of my favorite doctors to work with was Dr. F. He was of middle eastern descent, and had emigrated to our country. I thought of Dr. F after Sept. 11 happened. That sweet man (well, as sweet as doctors tend to be). I could only imagine the patients in the ER who bitched about the wait one minute, and refused to be seen by Dr. F because of his race the next. I wondered about how people treated him on the street when he wasn’t wearing his stethoscope and scrubs. People who probably would go their whole lives and never come close to giving the amount of help to their fellow man that Dr. F gave in ANY ONE MONTH of his life. These same people would be the people who would look down on him and treat him like crap because of his race. I’m not talking about “getting extra attention in airport security” treatment. I’m talking “throw a brick through the front window of his home” treatment. I hope Dr. F didn’t have to through any of that.

It can be hard not to be prejudiced. For example, I have a prejudice against the “males who seek out female bloggers and troll their blogs because their mother didn’t breastfeed them as a child or some fucking reason like that” race. That’s just wrong! I shouldn’t stereotype like that.

Bottom line: no one has to be racist. It’s totally unnecessary. Do what I do and hate people based upon their INDIVIDUAL MERIT.

Get to know people on an individual basis. They’ll give you plenty of reasons to hate them soon enough. You do not need to go and hate based on race, class, education, gender, or religion. Save your hatred and use it wisely, that’s what I always say. Just some advice from Auntie Mary.

Rumor: “Enter an ICE (in case of emergency) listing on your cell phone so the paramedics will have an emergency contact for you! Do it now or you will die! Run, run! Live in fear and panic! Then forward this to 400 of your closest friends because forwarded emails containing half-truths are an asset to our society!”

Oh, give me a break.

I started out as an EMT, then a Paramedic, then I went on to become an ER/Trauma nurse in the late 90’s, so I think it’s safe to say that I am allowed to have an opinion on this matter.

I do not have an “ICE” entry on my phone, nor will I. It’s just not necessary.

1. It’s not the paramedics or the ER staff treating you that will contact your family; it’s the cops or the hospital social workers/chaplain/admission staff. They will look in your wallet and/or medical records for an emergency contact.
   
   As a paramedic, I’d love how I’d be doing CPR on someone, my partner and the fire crew scrambling, and the family member would say, “Call my uncle James and tell him to meet us at the hospital!” Um, no. Kinda busy now.
2. Looking in a wallet is much quicker and easier than trying to figure out the phone book on infinite models of cell phones.
3. You need more than one emergency contact anyway.
4. Your cell phone may not be with you, or may not survive the incident that rendered you unconscious or dead. Most people always carry a wallet, and a wallet doesn’t need to be charged, and can survive a high-impact motor vehicle accident just fine.
5. Important info (medical conditions, allergies) may not be easily obtained from a shocked and traumatized emergency contact, even if they are reachable. WRITE IT DOWN. Medical history, meds (including dosages), allergies. DATE it. Carry it with you in your wallet. (Medical professionals always look in your wallet — FOR AN INSURANCE CARD! Ha ha, I slay me! But it’s true.)
6. If your cell phone IS with you, and survives whatever has tried to kill you, it’s pretty easy for the cops or whoever to find your last name on your drivers license, then call all the people with the same last name in your cell’s phone book. Don’t have the same last name as your family? Then put an emergency contact card in your wallet, since (are you getting the message yet?) they will look in your wallet first!

Your cell CANNOT store an easily-accessible database of your medical history, meds, or allergies. (Emergency personnel won’t have the owners manual to learn how to work your model of cell phone, even if it does have a PDA type of function, and they don’t have time to figure it out.) Contacting your family is secondary to providing lifesaving care. Having an emergency contact number is a bonus, but again, it can go in your wallet. A second easy-to-find emergency info card can go in your cars’ glove compartment. A third emergency info card can be taped to your refrigerator door at home. Medics should ALWAYS check the door of the fridge (that’s where medical info/DNR orders have been posted for decades). Because, what if you’re home alone and have to call 911, and you’re unconscious by the time they get there? Medics and cops don’t have time to be searching your entire house for prescription bottles and your stupid goddamn cellphone for the stupid goddamn ICE information.

While we’re preparing for emergencies here, how about putting some house address numbers on your house that can be seen from the street at night by some living creature other than an eagle with bionic eyes and night vision goggles?

How much do you want to bet that at least 30 percent of the people frantically entering “ICE” info on their cell have no easily visible house numbers that would allow fire/police/EMS to find their house in an emergency.

To summarize: Please, for the love of God, stop forwarding those stupid ICE emails! ICE info, if found at all, will not be looked at until AFTER looking in your wallet. There’s so many other things you can do that would better help out emergency personnel in case the unthinkable happens.

PS - Signing an organ donor card is meaningless if your family will object to the procedure. Make your wishes known to your family that you want to be an organ donor if the worst happens.

I know you want to be an organ donor because only stupid, selfish, ignorant pieces of shit would refuse to donate their organs, and people like that don’t read my blog.

This story on Alas, a blog reminds me of the ethical problems I have with FAITH-BASED OPINIONS on health care being LEGISLATED.

In fact, I have big problems with any entity telling me how to be a nurse, based upon their religious opinion. Even though I do think religious hospitals have a right not to provide certain medical procedures they object to (in certain, non-emergent circumstances), I don’t think they should withhold information about treatment options from patients. Stick with me on this.

When I went to (a very Catholic) nursing school and went to work in (a very Catholic) hospital, I was still Very Catholic (I have since recovered), and very concerned that I would be asked to assist with an abortion some day, so I purposefully avoided working in a hospital where that would ever be asked of me.

But I would NEVER morally be able to say to a rape victim, a desperate single woman who has no support, or to someone who would die if they remained pregnant, “Sorry, I can’t talk to you about where else to turn for abortion resources and information because it’s against my religion.” (Or my religion at the time, since I haven’t been Catholic since some Colorado priest said I had to vote for Bush or go to hell.)

When I signed up to be an RN, I did so fully knowing that I would have to put my PATIENT’S welfare above my own judgments and opinions.

To me, becoming a medical professional then saying that you won’t give patients certain medical information is the same as joining up for the military, then expecting special treatment because you don’t “believe in” war.

A Jehovah’s Witness friend was an RN with me on the Intensive Care unit, and you didn’t hear her whine and spew about giving blood transfusions. It was against her religion, but it was her JOB and it was what was medically best for the patient so she did it.

If you’re an RN or a doctor who doesn’t believe in elective, non-emergent abortions, then by all means don’t work where you’d have to be a part of giving that procedure.

However, sometimes your patients will need information about where to receive services that you don’t personally find “moral” (such as abortion, birth control, tubal ligation/vasectomies, or emergency contraception), and by God it is your DUTY to tell them that these things are options, and where else to go to get more information. Especially if the information is time-sensitive, like EMERGENCY CONTRACEPTION.

When I worked for one of those “ask-a-nurse” lines, we’d get callers asking about emergency contraception all of the time, and I wasn’t allowed to tell them anything because I worked for a faith-based hospital.

As an RN I found this in direct conflict with my duty to provide my patient with information that was the best for them medically.

Although EC is not the magic-fluffy-unicorn-and-rainbow-gumdrop-smiles pill that some people seem to think it is, it’s potential dangers and side effects are certainly less than having an invasive medical procedure like an abortion.

Again, let me make this perfectly clear: Although I think it’s a faith-based hospital’s right to not give treatments that their viewpoint considers murderous, I think it’s irresponsible for them to withhold medical advice about treatment alternatives that are as TIME SENSITIVE as emergency contraception. The delay in seeking EC may cause the patient to eventually need an abortion, which has more medical risks for the patient.

Isn’t the medical profession all about doing what is the best thing for the patient’s health?

Also, even faith-based hospitals receive huge amounts of government money (medicare, medicaid). So I do think they have some responsibility to all patients, not just ones that believe in a particular religion.

So, when callers would call the ask-a nurse line asking about EC, I’d tell them (as required) that the ask-a-nurse line is operated by a faith-based organization and I was not allowed to give any advice about the morning-after pill.

But then I’d add, “You need to call your doctor RIGHT AWAY or go to a non-religious ER right away to receive that information.”

Do you see what I did there?

I could have been fired for saying that (and the religious zealots of the organization called us trying to trap us all of the time, so it was a huge risk for me to say that).

You’d think the caller would get the hint, right?

Here’s an example of a typical conversation (usually it’s the male callers that get all pissed off; the female callers seemed to catch on):

Caller (mad): What do you mean you can’t give me that info? That’s your JOB!

What I wanted to say: Hey asswipe, this call is free and you’re not paying me. Your recent promotion to cashier at the Texaco is not equivalent to bachelors degree in nursing so don’t tell me what my job is. Besides, I just risked my job telling you what to do anyway, even though it’s not my fault that you’re too selfish, stupid, irresponsible, and impulsive to wear a condom!

What I said: OK, let me repeat to you that I’m not allowed to tell you anything, and that I’m not allowed to say that YOUR GIRLFRIEND NEEDS TO BE SEEN IN A NON-RELIGIOUS-BASED ER OR NEEDS TO CALL HER DOCTOR THIS WEEKEND.

Caller (even madder): Why can’t you just fucking answer me and tell me what we need to do!

Me (pissy, and talking slowly like I was talking to the stupidest asswipe on the planet, which I was): Think about what I said for a moment. I said that I’m not allowed to tell you that your girlfriend only has 72 hours from the time you had sex to seek emergency contraception, that you’re running out of time, and that you cannot get this service from any religious hospital. I’m NOT ALLOWED TO TELL YOU what I JUST TOLD YOU.

Rocket scientist: Whatever. Thanks for not helping me, bitch! *hangs up*

Me: Please God, don’t let that stupid fuck breed.

See, even if I thought that emergency contraception was murder (and having been raised Catholic, we were taught to believe that life begins at conception, not implantation, so it would be murder according to my religion), it is still my duty to give the patient time-sensitive medical information that is best for their health.

That’s why I said what I was not allowed to say at the nurse advice line. If they called and they’re 12 weeks pregnant and want an abortion and are having no problems, I would go by the rules and them we were faith-based and they would have to go somewhere else for the information, because it was not a time-sensitive issue and they would have time to wait until Monday to call Planned Parenthood or their doctor. However, with EC, there is often not that much time. I would have rather lost my job than violate my duty to do what was best for the patient medically.

Please tell your friends: EC is not without risks and side effects, so don’t consider it something that you can just casually pick up, like a pack of gum. It’s best to plan ahead and use birth control than think, “Oh well, I’ll get laid tonight and just pop some EC in the morning.” However, EC is much better medically and emotionally than having an abortion later on, so if you ever need it, you must take it within 72 hours of having sex, and you won’t get it at a religious hospital.

PROTIP: If the hospital name has the word “Saint” anywhere in it, you won’t likely be getting EC there, depending on the ER doc, so don’t even try.

Also, Planned Parenthood is your FRIEND.

Know your EC and birth control facts BEFORE you need them, because if the article at Alas, A Blog (and my personal experience) is any indication, you may not be able to GET the information when you DO need it.

Last night was the first “deputy in distress” code I’ve experienced since working at the jail. When the call came out over the radio, I looked at the other nurse I worked with and we were both thinking the same thing: BETTER NOT BE FUCKING WITH OUR OFFICERS! OH NO YOU DIDN’T!

The deputies don’t always like or respect the nurses at the jail. Sometimes we make more work for them, like insisting that the person blowing a 0.425 gets a medical clearance from an ER doc before we accept them. That’s when they try to tell us that the firefighters have already cleared them medically.

Excuse me, but firefighters don’t work here, are not bound by the standing orders written by our chief medical officer physician, and aren’t the ones who have to take care of the inmate. Also, just because they have penises does not mean that their medical wisdom is above mine. I respect EMTs, because I started out as one. I respect paramedics, because I was one. But then I went on and became an RN, and I now have 15 years medical experience. Don’t make me fucking discuss my resume and credentials with you just because I have a uterus, K?

ANYWAY, back to my point. The deputy being “acted upon” by the inmate ended up being OK.

But it reminded me that my old code of “any officer in uniform is MY officer, and ya don’t fuck with them” that I had from my EMS days is still alive and well. Even though, as an RN, the officers don’t have the respect for me and the comaraderie with me that they had way back when I was a paramedic.

After the incident, the other nurse and I were talking with the sargeant about how pissed off we would have been if the inmate had actually hurt an officer.

In conversation, both myself and the other nurse relayed to the (male) sargeant that we felt that way despite the fact that we had been let down by/had reason to be mistrustful of police agencies in the past.

As our stories spilled out, I was shocked at the sheer number of times that both of us have been let down by select few officers (in other states).

Once, she had called the cops because she had a restraining order against her soon-to-be ex-husband. They showed up and stood around and watched him beat her. Then, after he had broken two of her ribs and her nose, they put HER in handcuffs. Why did this happen? Her husband was a police officer.

I didn’t even try to call the cops when my (now ex) husband turned from emotionally abusive to physically abusive. He was a firefighter, and even though the cops in my hometown were awesome for the most part, I knew from my EMS days they have no sympathy for battered wives, and they have a lot of allegiance to firefighters.

Also, once I was in an accident where a man tried to make a left turn from the far right lane and crashed into me. The officer that responded FROM THE DERBY, KANSAS POLICE DEPARTMENT (yeah, I’m talkin to you!) tried everything to frame me for the accident. Let me make it clear: I was driving straight down the road when someone TURNED THEIR CAR AND SLAMMED INTO MINE. It was very clear that I was 0% at fault. The cop even went so far as to say that it was my fault the guy hit the right side of my car, because my front driver-side tire was 8 inches over the double yellow line on the left side of the car (where my car was pushed when the other guy crashed into me). The guy even told the officer repeatedly, “Hey, it was MY fault! Why are you trying to blame her?” (Even though he later “caught on” to the officer’s intentions and told his insurance agency that it was my fault. I was still found blameless in the accident.)

Ya know, I still can’t believe that happened. It was fucking UNREAL. Power in the wrong hands can be a frightening thing.

But despite these bad experiences, and some other bad experiences since, I will always have the utmost love and respect for law enforcement officers. Every profession has its assholes. But if push came to shove, even the asshole cops out there are willing to DIE for STRANGERS.

How can you not be loyal to that?

I still hope the cop that tried to blame me for the car wreck gets infected hemorrhoids and chronic explosive diarrhea. Rot in hell, ya woman-hating bastard!

But for the rest of you in uniform out there — you may or may not treat me very kindly if we ever cross paths (I’m not a cute, thin young thing in a miniskirt any more), but I still send you much love and pray you stay safe. Thanks for everything that you do for all of us.

Inmate, to me: “YOU get your fucking FAT ASS down those stairs and get me some tylenol, NOW!”

What I said (calmly): “We’re done here.” I shut the cell door pass-thru and walk away, as the deputy locks up and the inmate continues screaming for my death and throwing things in her cell.

What I wanted to say: “I may be fat, but I can lose weight, and you’ll never lose your chronic and debilitating case of ‘crazy scumbag whore’. Not only is my fat ass going to be sleeping in its own bed tonight, but I think I’ll take some tylenol right now, just because I can. Bitch.”

Yesterday, I was talking to another nurse at the jail, and I asked her about treating inmates that have committed crimes that she found particularly reprehensible. She of course said that treating child molesters, especially incestuous child molesters, was difficult for her.

I started trying to think about what my limit would be. Of course, nobody likes a child molester, but I can distance myself from the reality of such a heinous crime since I was neither a victim as a child, nor do I have children now.

Would it be rapists? Because goddam I hate me some motherfucking rapists! Wifebeaters? As a former receiver of emotional and physical domestic abuse, I would think that would be it, but half of the guys in there have restraining orders against them and it hasn’t bothered me so far.

Then later, I was talking to another nurse who told of working a prison riot in a different state. I never realized how many times the most horrible details of crimes are not released to the public, and this prison riot was no exception. She told of what the inmates did to other prisoners. Horribly tragic. But then she told of what the rioting inmates did to the guards, and it was then I felt it. That overwhelming hate and anger towards a perpetrator of a crime that I couldn’t squelch or control.

That one thing I don’t think I could look past, even long enough to be professional for 30 seconds, is a crime against a law enforcement officer.

So I’ve discovered my own personal “hot button”, and it’s up to me to figure out how to get over it before I actually have to face an inmate who has raped, shot, or killed someone in law enforcement.

Don’t get me wrong… I would never withhold appropriate medical care from anybody.

But how do you treat an inmate professionally when the whole time you just want to scream at them: “I HOPE YOU ROT IN HELL, YOU MOTHERFUCKING PIECE OF SHIT THAT SHOULD HAVE BEEN ABORTED!”

I’m about to leave for day 4 of my new job as an RN at the jail. So far, I find the inmates much more courteous to the nurses than patients in the hospital are. Of course, many lie and try and manipulate you, but it’s to be expected, and truthfully it’s no different than working on EMS or in the ER.

The funny thing is that people really cop a ‘tude (ha ha, get it? “Cop” a tude? I slay me!) when I say I’m working in a jail. They act like it’s the bottom of the barrel, like I’m too scummy or incompetent to get any other job.

Truth is, this is much better than working in a hospital. Sure, I’d rather have a desk job and never have to interact with another patient or doctor again, but this is just fine in the meantime. Although the inmates often want a constant flow of pills for EVERYTHING, even if you don’t give it to them they seem to appreciate just being treated like a human being.

Think about how awful it would be if we all walked around with a sign on us that listed the most horrible, low crap we’ve ever done in our lives, and that everyone we met read the sign first and judged us on only those lowest, most despicable actions. Would be awful, wouldn’t it? I imagine that’s how these inmates feel.

I think the scariest part of it for me is that, after talking to some of these people, I find they are really not any different than myself or anyone else I know.

Of course, it’s impossible to find sympathy for the guy who is in jail for his 8th DUI or for being a sex offender, but some people are in their for just one mistake, and this mistake is going to haunt their lives. They had to tell their employer they were in jail. If in for a while, they lose their house and may be in financial ruin by the time they get out. If convicted, they will have to list their offense on every job application. They run up huge lawyer bills. But most of all, their self-esteem takes a nose dive.

As one woman said to me: “I never thought I’d be in a place like this. This is not who I am!”

Not only do others see you differently from that point on, but you see yourself differently, and it’s defeating.

I am treated like less of a human being by many people I meet since I gained weight. No eye contact, not treated with the same courtesy as a thin person would be, and treated like being fat somehow equals being stupid or worthy of scorn. Can you imagine how people with a record are treated?

With the judgmental attitude people have today, is there ever really such a thing as someone who has paid their debt to society? I strongly suspect there isn’t, and that people who end up in jail continue paying that debt over and over. If you’ve been in jail, I don’t think that mistake is ever really behind you. And that gives you even less to lose if you mess up again, so why try?

It makes me sad.

Monday I start my new job as a nurse in a jail!

It has got to be more exciting than writing patient education handouts.

Cops in uniforms. Yummy!