Let's get one thing straight: nursing is nursing. There aren't a lot of differences between the way a nurse one one floor cares for a patient than in any other part of a hospital. You assess your patient, you administer medication, you document what you did.
The working environment of each department is where the difference is felt. Choosing what type of nurse you want to be can be a confusing process, but it is important because it means what you want your work day to feel like. So to see where you fit in, here is a breakdown of four basic types of nursing available to new nurses, based on how they would fit into Hogwarts School Of Witchcraft and Wizardry from the "Harry Potter" series. There are other types of nursing than what are mentioned here, of course; oncology isn't included because that requires extra training, and pediatrics and neonatal are pretty self-explanatory for nurses who want to work in those areas. And also, I ran out of houses.
Want to see in which hospital department the Sorting Hat would place you?
Hufflepuff: Medical Surgical, Med/Surg
Hufflepuffs are loyal, patient, kind, and they work hard. It was claimed that Hufflepuff House would take any student, and that made it nothing more than a refuge for those who simply didn't fit in to any other house, but that perceived weakness is unfair. Hufflepuffs like being surrounded by lots of friends, they don't judge who you are or where you're from as long as you're good peeps, and they're happy for anyone to come hang out and chill with a butterbeer or two. It's a lot easier to get what you want when you're nice to people and you aren't ready for a fight all the time. (Perhaps this is why Hufflepuff House has graduated the least amount of Dark Wizards and Witches from Hogwarts.) But don't let that friendly demeanor fool you. Nymphadora Tonks was a Hufflepuff and she could kick your ass.
The Med/Surg floor of any hospital is where patients go when they don't have a specific problem to put them somewhere else. Med/Surg nurses handle a little bit of everything: infectious diseases, geriatric psych, alcohol detox, gall bladder removal, they've seen it all. They must be very thick-skinned, and the good Med/Surg nurses know how to smile through the chaos. That smile makes a big difference to the patients. Walking from a room where an elderly patient is sundowning and is trying to escape the hospital, and then going directly into another room with a patient with C. Diff. with uncontrolled diarrhea, can be emotionally taxing. But Med/Surg nurses must not only treat what ails their patients, but preserve their patients' dignity.
On a Med/Surg floor, you will run constantly and get yelled at from all angles, but you'll learn a lot about nursing, healthcare, and life in general. Just be ready, because it can be rough.
Gryffindor: Emergency Room, ER
Gryffindors are well-known for being adventurous and courageous, and are often looked at as being natural leaders. They won't hesitate to rush off to battle, ready to save the world, and they will do it all with great aplomb. And they're really good at what they do. Albus Dumbledore, Grand Sorcerer and all-around best badass wizard on the planet, was a Gryffindor. People love Gryffindor. Gryffindors are winners.
ER nurses get all the excitement. Broken bones and gun shots, pregnant women in labor, all the action is happening in the ER. They'll run around the room and treat 10 patients at the same time, and remain totally calm while a patient is brought in by helicopter and is laying on a bed screaming in pain. Although don't be fooled — just as Gryffindors must endure taking classes in Ancient Runes and Numerology, ER nurses must also treat people who come to the Emergency Room with headaches and rashes. There can be long lags of those mundane patients before anything exciting is seen. And just as Gryffindors had to do a lot of homework, ER nurses spend a lot of time charting incoming patients and the many details of their health. Charting, charting, charting.
Things certainly move along fast in the ER. The patients don't stay there for long before they are wheeled away to the appropriate hospital department, so there isn't as much emotional bonding going on. But who has time? Next!
Ravenclaw: Ortho/Neuro/Trauma, or Tele
Ravenclaws are the intellectuals of Hogwarts. They enjoy learning just as much as they enjoy the competition of academic achievement. However, they are also fiercely logical, as they recognize that it doesn't matter how much anyone learns as whether a person knows how to use that knowledge. Sometimes Ravenclaws are a bit introverted, but it's just because they'd rather be reading books than playing with the stupid toys from Weasley's Wizard Wheezes. And they don't really care if you think they're nerds. They too busy being successful to care what you think.
The ONT floor is for more complex recoveries from bone surgeries, back/neck injuries, or other traumatic situations in need of intensive treatment. The Tele floor is for patients on telemetry, the system of electronic heart monitoring, who have perhaps had a heart problem or have even undergone cardiac surgery. These two departments are completely different in techniques used to treat their patients, but the ideology is the same. Care here is very complex, and nurses must perform lots of documentation and follow strict procedural guidelines.
Each pin site holding a bone together after any reconstructive surgery must be assessed and documented. The EKG strips of a heart failure patient must be constantly analyzed and interpreted, for the nurse to choose and administer proper medication. Each medication's intended effects and side effects must be known perfectly, to watch for any sudden changes in a patient's status. And those changes happen very, very fast and can be deadly.
Doctors aren't there telling the nurses what to do; the nurses must use their heads to know when a patient is healing properly, or when to alert the doctors that changes need to be made in a patient's plan of care. There isn't a lot of time for antics and goofing off when you're on one of these floors. But for those nurses who thrive in a situation of structure and well-defined expectations, ONT or Tele is a place where a nurse can make excellent use of his/her critical thinking skills.
Slytherin: Intensive Care Unit, ICU
Slyterins are cunning, resourceful, ambitious, and independent. Some people think the Slytherins are difficult to work with, and it is true they can come off a bit frosty, but it is only because they are determined to do whatever it takes to achieve their goals.
Although they can sometimes be uninterested in being friendly, Slytherins really do have the best of intentions. Severus Snape is perhaps the greatest hero of the Harry Potter world, despite his scowling demeanor. His critical diatribes against Hogwarts students were harsh, but Snape usually wasn't being mean; he just didn't sugar-coat anything.
Nurses in the Intensive Care Unit must be tough. On other units, a nurse works with support staff to assume partial responsibility for patients, but in ICU the nurse serves the patient one-on-one. They need to know how to do everything. These nurses must think quickly on their feet, they must be resourceful and entirely self-sufficient, and above all else they have no choice but to do whatever it takes to keep their patients alive. Everyone else, just get out of the way. ICU nurses don't have time for your nonsense.
It should be noted that when nurses on other floors need to accomplish difficult tasks, such as starting IV lines, they usually call a nurse from ICU to come help.
I am finally finished. After three years of taking classes, starting with A&P I because my pre-requisite courses from my first time in college were taken too long ago to be valid, through my final clinicals of nursing school, then taking the state boards, and finally navigating the "new grad" training program at my job, I am being turned loose to go to work. No more classes. No more safety nets. No more excuses. My first shift, on my own. For realz, with a pocketful of needles.
There are things I wish I had known when I started this process. Some things need to be learned on your own, but I will try to share my thoughts, to shed some light on the process perhaps for you, Dear Reader, who may be thinking about turning your life upside down and giving nursing school a shot as well. Ha. "Shot." Get it? Nursing humor.
1) There are nursing degrees, and there are nursing degrees. Once upon a time, nurses were trained at little career colleges, where young ladies learned how to bandage wounds and mix salt into water for 0.9% saline solution, and they walked away with an Associate's Degree and a nifty white hat (and, if they're lucky, eventually a wedding ring from a doctor). Those little nursing colleges are still around and they kick ass. Seriously, go to one of them and you'll be a really good nurse. But times change, the healthcare industry is changing, and hospitals don't seem to be hiring from those little colleges as much. What happened? Universities have created nursing programs on the Bachelor's Degree level.
Associate's or Bachelor's, you're still a Registered Nurse, an R.N. You don't get paid more when you have a Bachelor's. It's just a title by your name, because you took some additional classes in leadership, community health, and nursing theory. It's a weird loophole — both degrees have the same license, so why bother getting the Bachelor's? Because hospitals get preferred treatment by Medicare if they have a certain percentage of their nurses with Bachelor's degrees, which means those nurses often get hired first.
Every hospital is different. Lots of hospitals prefer to hire people that they like, not just people with good degrees. But there will undoubtedly come a time, probably soon, when the Associate's Degree programs are simply phased out.
2) Check your school's accredidation. Anyone can start an accrediting agency. It doesn't mean that accredidation is worth anything. Most legit nursing programs are either NLNAC or CCNE. For example, those are the only two accredidation agencies accepted if you want to be a nurse in the U.S. military.
3) If you want to see what working as a nurse is like, get a job waiting tables at TGI Friday's. You run constantly, you have to remember a million things, people yell at you for no reason, your coworkers tell you things you need to remember while you are in the middle of doing something else and they make you lose your train of thought, there will always be people you can't please no matter what you do, and you have to clean up stuff off the floor. It can be chaos. If you can't handle remembering drink orders for a table of eight, you do not have the stamina to be a nurse. And getting two new patient admits at the same time feels EXACLY like being double-seated.
4) Compression socks. My God, they will change your life.
5) When you are looking for a nursing job, apply for jobs advertised as "New Grad." It is a specific job intended for people who just finished nursing school and don't have experience yet. Many hospitals refuse to hire below R.N. II, which is a nurse with 6 months or 1 year of experience. But other hospitals like hiring new nurses, because those new nurses can be moulded into the type of employee the hospital wants. The hospital will pair you with a preceptor for 6-12 weeks and basically put you through nursing school again.
6) Before you enter nursing school, or even while you are a student, if you can get a job as a Medical Assistant, or a Unit Secretary, or anything in a hospital where you have interaction with patients — not just a volunteer who delivers flowers — that will help you a lot in your job search. Work PRN while you are going to school. PRN means "pro re nata," which is Latin for "as needed," as little as a shift or two each week. Although Medical Assistants and Unit Secretaries are still specialized positions with skills involved, but that's another story.
7) It's okay if stuff about nursing grosses you out. You just have to fix your face for a few minutes while you're with a patient. You can hold your game face for three minutes. And the first time a patient, who is also someone's grandmother, looks at you with shame in her eyes because she couldn't make it to the bathroom in time, you will learn what it feels like to put aside your own worries and give another person some help.
8) ...and there are people who help you with some of that stuff anyway.
9) If a person asks you for Dilaudid, he/she is in pain. If a person asks for Benadryl after Dilaudid, he/she is having a problem with itching from the Dilaudid, which is a common side effect of the drug. If a person asks you for Dilaudid, and Benadryl, and Phenergan, the Benadryl and Phenergan together increase the high of the Dilaudid, and he/she is quite possibly a drug addict looking for a fix. How you handle it is your dilemma. You will have to make these decisions. If you cannot handle these decisions without passing judgement, you do not have the stamina to be a nurse.
This is at Nebraska Furniture Mart. Yes, there is a store called Nebraska Furniture Mart, and it is glorious. Kansas City is in Missouri, and Nebraska Furniture Mart is in Kansas. It's crazy here.
And seriously this chair is outrageously comfortable.
Second, I am starting a new column at GayCities.com. I have been an on-again/off-again editor there for years, writing when I feel like it and quitting when someone does something I don't like which causes me to throw a fit. But now I'm back again, writing when I'm not working at the hospital. And I need some suggestions for the title of the thing.
The inspiration came from all these stupid companies that don't want to do business with gay people. I.e., 111 Bakery in Indiana said they wouldn't make a wedding cake for two guys getting married to each other. Gay marriage isn't legal (yet) in Indiana, but they can get legally married in another state and then come back home and throw a big formal event. Of course that big event must include a cake! But 111 Bakery doesn't want to be responsible for making it.
It's all just so ridiculous, but whatever.
So this new column shall highlight businesses in the U.S., obviously being the vast majority of businesses in this country, that are perfectly happy to provide good customer service to (and take money from) gay people just like everybody else. We're going to show places that are unique, interesting, or otherwise fun. Also, we're showing how much more there is to the LGBT community than just gay bars and Speedo shops. Not that there's anything wrong with gay bars or Speedos. But there's more out there. And we're going all around the country, not just big cities with big concentrations of the gays and the lesbians and the other relateds.
Sooooo, the powers-that-be at GayCities want me to come up with a name. They want something jazzy, without the word "gay" in it. Because, well, look how many times I have typed the word "gay" already just in this explanation. I have been instructed to develop a brand, not just a name.
I then walked into Bed Bath & Beyond, looked at all the different possibilities for a shower curtain, and hyperventilated.
A few months ago when I moved out of my apartment in South Beach, I took everything in my kitchen, my awesome lamp collection, and countless boxes of clothes. The rest? I'd rather not say where it is. It was ugly anyway.
But back to the hyperventilating. Even if I had taken my stuff, I had lived in a studio. I rented this studio month-to-month for eight years, my landlord never raised my rent, and it always felt like I was on vacation because South Beach is such a shithole it's impossible to form any sort of permanence. If you came over for a visit, you sat on my bed because there was no place else to sit. But now in this new apartment, I have, like, rooms and closets and shelves that stand expectantly awaiting the arrival of knick knacks. Where does one acquire knick knacks? I don't collect stuff. It reminds me of time gone by. To quote Edna Mode from "The Incredibles," I never look back, darling. It distracts from the now.
So I have to buy everything. EVERYTHING...except for the aforementioned kitchen stuff, thanks to my assortment of Fiestaware, which my mother would buy for me whenever Macys.com had a sale, and send it to me--which means I now have to pay to move several boxes of Fiestaware dishes that were bought on sale but have now cost three times what they would've cost if I bought them new. But you can't put a price on sentimentality.
This story isn't about Fiestaware.
I have spent years floating through life, doing stupid TV shows and getting roles in schlocky plays, and it was like I had joined the circus. I lived on the road and stayed in random apartments and in awful 1960's motels, which actually are my favorite because they are so romantic. Every place had its own appeal. I had just as much fun in St. Louis as I did in Paris. Although the food in Paris was much better. But my goal was to figure out what I want to be when I grow up before I hit the age of 40. So I went back to school and I now have a job, which I start next week, and I'm 39 and a little extra. Phew! Made it. Barely.
There in Bed Bath & Beyond, with those lights and perky employees which are both somewhat smothering, I walked past a collection of bathroom mirrors. And as I often do when I pass a mirror, I looked. But this time, I stopped and really looked. This is it. This is who I am now. I looked at the gray hair growing on my earlobe over the scar from where my earring used to be. Old. Life is moving by and there's no going back.
So, I thought, I have a new apartment! Congratulations, Self. I guess I need a shower curtain. So I turned, and I took a step, a step, a step around the corner to the shower curtains. Okay. I looked at all the choices, too many choices, and all the colors swirled together and it became hard to breathe and I speed-walked out of the door.
I can't be expected to think of everything. How do people do this? How do people keep making these decisions constantly about their future and repeatedly make commitments with long reaching implications that can't even be contemplated while the decisions are being made? I don't know what kind of a shower curtain I want! And then I need a couch and a table and a TV and a desk for my computer unless I just use the table maybe and a bed and sheets for that bed and towels but the towels need to be the right color for when I hang it to dry next to the shower curtain.
Bed, bath, and beyond, indeed.
I'm an adult.
It finally happened. Peter Pan can't fly anymore, and Tinkerbell has left the building.
But it's been a while since I've been excited for anything. And I'm pretty Goddamned excited for all this stuff. Anyone else who will be there, please excuse me during our New Employee Orientation next week because I'll be sitting in the front row and asking lots of questions.
I have writer's block. So, let's procrastinate and look at magazine covers, shall we?
Perhaps I'm the only person on Earth who still reads magazines. I also still talk on phones. Although I made my phone out of a rock, like Fred Flinstone. Stone Age.
So I still read magazines, but they are often so disappointing. The evidenc:
I wasn't aware we are still paying attention now that the "Twilight" movies are over. It's so boring, she can barely keep her own eyes open just thinking about herself as the cover story. I agree.
But I'm not the target demographic so I'll move on.
On to a legitimate issue. Here is the "fashion issue" for Details, featuring the biggest models of today. I have complained to the universe many times about the lack of racial diversity in American media, particularly the fashion industry--which theoretically inspires our idea of how we should look--as if we Americans are too stupid to comprehend "beauty" as anything other than a white face. Granted, some of these models are Latino, but the effect is still the same. Racism in the media is so common, we have become desensitized to it and don't really react to it anymore.
When I was with a modeling agency, our composite cards were held in bins on the wall; there was a section of the wall devoted to "ethnics," meaning anyone who wasn't white. So if you wanted someone who didn't look white, you had to go over to the corner and specifically pull those cards. It was ridiculous. And every agency was like that.
Speaing of racism in American media,
My friend pointed this out to me. You have to read the article to understand the angle, and here you have to log in, so I'll sum it up: it's about a high school in the South Side of Chicago that has partnered with IBM to promise a job to anyone who graduates, but their school runs for 6 years, with 4 years of high school and 2 years of college. Pretty cool. Here's my issue: the South Side of Chicago is a mostly-black neighborhood. It even says in the article, the high school is an almost all-black school. Yet they put a white guy on the cover.
Does it really make that big of a difference in sales that they can't put a black student on the cover of their magazine? Are the readers of Time really this racist? Or maybe it's just the editor? Although there are almost no ads in Time anymore anyway, since advertisers don't want to throw away their money anymore on a magazine that almost nobody reads, so it doesn't matter much.
Backstory: Mom and Dad are watching my cat, Gurdy, while I am traveling.
Mom: I'm worried about Gurdy because he looks so thin. I weighed him and he weighs 10.3 pounds. I looked on the internet to see how much cats should weigh, and I saw a story that said they should be 1 pound for every inch of shoulder height. But when I try to measure him, he plays with the ruler and thinks it is a toy. So does 10.3 pounds sound right to you?
Mom: I gave him some wet food last night but if he eats too much he gets gas.
There are two Shar Peis currently in my care. I am watching over them for a friend who is out-of-town for "the holidays" and such. As is true of the breed, they are calm, reserved dogs who also happen to be affectionate and very good-tempered. Good-tempered, or well-tempered? I think good. Anyway--they are really nice dogs.
Although I introduced Gurdy the Cat into the mix, and not everyone shares that sentiment. I particularly mean Gurdy. He wasn't happy about meeting them. At all.
Gurdy is not a fan of anything that walks on four legs. He had a particularly unpleasant (yet entirely harm-free) encounter with the neighborhood raccoon last year; since then, all quadripeds are out of favor in Gurdy's eyes. Nope. Upon meeting a friend's cat, Gurdy retreated to a corner and bowed his head in pathetic subservience, until I picked him up and took him home. He also doesn't particularly like birds, as they would swoop past his window where he'd sit in the sun, and it scared him in such a manner that he fell off his ledge a few times. And that was funny. Poor Gurdy. The world is full of dangers.
But back to the Shar Peis. So Gurdy is NOT a tough cat. He's part Siamese, so he's very small and bony; he has slightly crossed eyes, so he doesn't have the best aim and occasionally bumps into immovable objects. Not that he cares. He jumps around and plays constantly, leaping around the room like a parkour aerialist and chasing flecks of dust. However, when I brought him in to meet the dogs, he found the nearest bed and scooted under it. The dogs came over, gave the border of the bed a sniff or two, and then got bored and moved on.
For two days, Gurdy lived beneath that bed, emerging only for sustenance or litter box-related issues. I knew he'd get bored eventually, and emerge. Finally when he did come out, he slowly skulked around the room. The dogs watched, then sniffed, and then followed and sniffed, until they were both face-to-face with this strange, invading cat. Gurdy, for his part, sauntered into the middle of the room, and sat politely--with his ears back, eyes wide, completely still. A few feline growls ensued, followed by a canine growl and some huffs. Everyone moved very slowly, methodically, tentatively. Except for me. I just waited. Because it was obvious something was about to go down.
I don't know if he had been just sitting under that bed getting angrier with each passing minute, or if it took him that long to work out the details of his attack, but either way he was finished with living under the bed and he was out there on the dogs' turf looking for some trouble. And he was looking for it--straight at them, ears back, eyes wide. Mmm hmm. Let's work this out, right now. One of the dogs leaned in, staring down Gurdy as best as he could, and went for a too-close sniff.
Those Shar Pei muzzles are so big and fleshy, aren't they?
Gurdy, in what can be best described as a scene from "Kung Fu Panda," ejected himself up from the ground, leaped into the air and attached himself to the dog's face. BAM, one perfectly-aimed slash right across the snout. But as the dog snorted in shock he used the momentum of that strike to push himself down to the floor, and he bounced back up to give a few swipes to the other dog across the nose, who just yelped in dismay. Gurdy then rotated mid-air backwards, and upon landing he didn't miss a stride and took off running. It was almost beautiful, his aerial acrobatics. The dogs, and I, just sat there. Although only one of us screamed like a girl, praying the cat would not soon be murdered.
So the dogs chased after him, but it was too late. Gurdy was under the bed, howling, as they swerved back and forth along the edge barking and snarling. Not that they were very close. No, they stayed back at least a cat arm's distance. They're not stupid.
I put the dogs outside, and I waited a few hours to let Gurdy calm down before I went to grab him from under the bed. But there was no need. When I walked back in, he was sitting on a chair with his eyes half-closed, licking his paw. Perhaps he was upset his fur had been mussed in the fracas. Perhaps he was reveling in the taste of dog blood on his claws. I left him there, but he emerged a few minutes later and sauntered over to the sliding glass door. The dogs sat on the other side, looking in. Gurdy plopped himself down at the glass, and he did not blink as he stared them down, taunting them, like Daniel Day-Lewis in "There Will Be Blood."
The dogs, safe on the other side of the glass, turned. Heads down, they walked away. One of them glanced back at Gurdy while in retreat, and kept moving. Gurdy just purred, loudly.
Gurdy now sits in the middle of the floor. The dogs walk around him. Yeah. There's a new boss in town.