When you’ve been a nurse as long as I have, there comes this point where you’ve forgotten more than you know. When a patient’s heart stops and I begin CPR, the muscles take over and the motions are automatic. I remember when I would be so filled with pure adrenaline, I used to watch my hands tremble for hours after a cardiac arrest. I learned to take advantage of the energy rush and sharp mental focus that always accompanies the true fight or flight response. The years went by and my hands shook less and less, until nothing shook at all. Hence it takes a lot to excite me, hence my love for wild manly men and fast cars.
After several years, you develop the ability to kinda predict the future. Often I feel all but certain that a patient’s kidneys are about to say kaput in a day or two or that one slight wet cough is going to turn into a wicked aspiration pneumonia. It’s the physicians who always remind me that we can’t always treat what’s not yet there. Any good physician is always alarmed by the intuition of any veteran nurse. Sometimes we carefully watch and wait for a patient to declare themselves. Humans that have adapted to survive thousands of years will often surprise you and this is not a new idea. The human body thrives in a constant state of homeostasis and it is purely fascinating to watch this complicated process of self-regulation and help assist it back to a balanced state.
Rounds in the ICU are not like rounds in other parts of the hospital. We’ll sometimes round on one critically ill patient for an hour, until an urgent decision is made to halt rounds and start a procedure. In any designated Trauma Center, the doctors, anesthesiologists, CT scanners and operating rooms are always ready to go. I’ve also worked in Neurosurgical and Medical ICU’s, but prefer the Trauma ICU because yes I am a very impatient and “aggressive” woman. So working in trauma hits my need for speed, instant gratification and also suits my blunt communication style.
An important part of my job is to monitor and spot trends, whether it be watching a lab value that’s drawn every 4 hours hold steady, or fret over an alarmingly low, but good enough enough oxygenation saturation level. It is almost all very patient specific and dependent upon multiple factors.
The Nurse knows to always look at their patient because some patients can sit and smile with a heart rate of 150 beats per minute for a week or two, while others are instantly in complete and utter distress at this same higher than average rate.
Each day, the overall status of the ICU patient, including their vitals and trends down to the milliliter per hour of urine that’s produced, is monitored, reviewed and discussed. The communication in an ICU setting is so impeccable that I sometimes only need to ask a few clarifying questions to confirm the team is all on the same page. Sometimes we’re already there and I have nothing to add.
Oh and by the way I am required and obligated to question any provider order that doesn’t make sense. Any physician worth their salt knows this, we actually all understand each other’s roles and get along just fine. This is another reason why I no longer watch the TV that proliferates so many stupid and dangerous misconceptions for entertainment purposes.
Of course this doesn’t mean I’ve never slept with a surgeon. I’m saying it wasn’t in a supply closet, all involved parties were single adults and I outgrew that particular thrill a long time ago.
The human body is somewhat predictable, but the behavior and emotional responses of patients and their family members is never predictable. Upon hearing bad news, the nicest folks will turn on a dime and flip a bedside table or chair. While the baddest of the bad, might dissolve into a puddle of tears and slobber all over my scrubs. It is impossible to predict how people will react when faced with tragedy on the days I always know will come to be known as the worst goddamn day of a life. By the way, shame on everyone who posts pictures of their smiling kids proclaiming how they would just fucking die or cannot breathe without them.
Shut up and go live.
This summer I’ve spent a lot of time getting to know a man I call Hot Dad. We met in early June after I spent a hot minute with an unwell and childless man who had a dollhouse in his living room, along with a fake name I happened to discover while we were on our way to hike in a wooded area. You simply don’t know how people will react when confronted with darkness and their life is threatened. I am happy to report I am calm as can be, at least outwardly, and the experience only confirmed my suspicion that I too, would have been drinking champagne and listening to the band on the deck of the sinking Titanic. Now every night I pray for that particular man and hope he is well, maybe a little more honest as a result of our time together.
On my first date with Hot Dad, we sat at a cafe and shared our requisite histories and statistics. Hot Dad’s never been married and this is not a red flag for me. He’s had a few enduring relationships, but voluntarily shared he only wanted to do it once.
Touche. I’ve done it twice now with no regrets and I’d do it twice more to find the love we all deserve. It’s kind of hard to explain, especially on a first date, but I’m looking for the kind of man who looks at his dying wife and instead of seeing a bloated alien with a shaved head and ten tubes protruding from her battered body, smiles and kisses her. He sees only the beautiful woman and I know he is unable to see what I see.
I have my reasons for not divulging what I do for a living on a dating app, so on this first date with Hot Dad, I confessed I worked as an ICU Nurse. Then I sat ready to hear the post Covid accolades that I don’t want to hear anymore. Hot Dad looked unimpressed, looked me dead in the eyes then tells me his beloved mother absolutely hates nurses.
Let me pause and say that Pink is the only artist I will forgive for saying the nurse was being a bitch in her song, Just Like a Pill. I’m a big fan, so I was offended by these lyrics until I remembered that Pink’s mother was an Emergency Department Nurse in Philadelphia and I’d be a bitch too. No shade here, I graduated from Drexel University and Philadelphia is not always always sunny. Hot Dad originally hails from the lovely neighborhood of Kensington which also, is not at all like the namesake palace.
Disappointed, I sat there thinking so much for my third mother in law liking me. Remember now I predict the future, so on our first date I romanticized and played out our life together in my head. The trick is always to be aware of my tendency to do this and so don’t worry about me, I’m fine.
Most people sort of wrongfully assume nurses are angels. I laugh because I am certainly no angel and Hot Dad wasn’t looking for an angel. I’m not a saint either, but I am a passionate and dedicated nurse. I sat there silently as he told me why his mother hates nurses. Of course I won’t share their story, but will say they’ve spent most of the last several years in and out of hospitals. We talked about the reasons and the multiple miscommunications that had occurred in the heat of the moment. All the dreaded middle of the night decisions made by him, his mother’s only son and next of kin.
He asked so I then offered him some insight into what goes on behind the closed curtains in the ICU. Then he listened. Then he laughed and told me that he, after being kicked out of Catholic school, went through the Philadelphia public school system. Therefore I needed to “dumb down” any big medical words for him. This really set me off because if you can rebuild an engine or carburetor, well then trust me, you are perfectly capable of understanding how the human body works.
Frankly after all these years, I can explain anything in layman’s terms. By the way, the heart kinda looks like an ice cream cone with the atria on top. We had a great conversation on that first date. I don’t ever date unintelligent men, nor will I ever again dumb myself down for any man. I am not in any way smarter than Hot Dad and I made sure he knew I am only more educated. I told him it was perfectly fine to be upset with our healthcare system, I’m a little upset too. I suspected our political views differed slightly, so I warned him not to ever ask me about the pandemic if he wasn’t willing to hear what I have to say about the pandemic.
This doesn’t mean I’m a Democrat.
This topic is one of only two hard lines for me because I was there and he wasn't. But hey I do see a lot of strong women get the shit beat out of them by grown men who are almost always physically stronger, so we’re good. I don’t care if you agree with me or not. The Trauma ICU is my TV screen and this is what I see with my own eyes. I suffer from no delusions. For a minute there I thought that other man was going to kill me that day on the way to the woods. Pepper spray or not, I am certain I would be easily physically overtaken by a man.
This also doesn’t mean I’m a Republican.
Is there such a thing as the Reality party? By all means, let me know.
We didn’t talk about politics again until July and by then it was too late for either of us to worry about it. I know what it’s like to feel powerless, upset and betrayed, but it is never okay to complain if you’re not willing to learn the things you are all perfectly capable of learning. Where I come from we fight hard for what we believe in, so now I toss the ball back to you. Is there anything you would like to learn from me?
I said I didn’t like the game, I have never once said that I don’t know how to play.
P.S. A big middle finger to those who mistook my red Phillies hat to mean something else and suddenly stopped interacting.
Tell me, do you like my Patagonia one better?
Sure I know it could have been something I said, or my writing, but know this— every single time I change my profile picture or remove one three letter word from my description and watch my subscribers double, I am playing with you.
I see you America.
Assumptions are dangerous.
🖤
Your writing is so engaging, love your ‘voice’. I get what you’re saying about loving what you do in a system you’re not wedded to. I am a teacher … l too love what l do, working with kids in broken system that l have little regard for … in its blinkered restrictive mainstream labelling and outdated judgements. I think nurses and teachers have a lot in common about seeing sides of life that aren’t necessarily seen or valued by society. BTW, l have a great respect for nurses, l have little respect for doctors who mainly offer gratuitous advice, don’t listen to their patients and merely to serve the pharmaceuticals industry … that’s looking at how it goes down in Australia, in my opinion. Thanks 👍
ICU nurses and Emergency room nurses face many challenges most other nurses and doctors rarely encounter. They are quick thinking decision making skills are second to none. I’ve noticed that take-charge-persona spills into their personal life and they become mama bears in mama bear wives at home, sacrificing much because that’s their motherly nature. I’m sure you are a blessing to your beloved children. 🫶
Kristin you’re a gem Hot Dad should hold tight, and not let go! 💎🥰