Nurses are nuts or do they just need “secretaries?”

 

Nurses Are Nuts by Anthony Langley, RN

 

 

 

 

Anthony Langley contacted me to ask if he could send me a copy of his book to review and possibly discuss on my Blog. I am always happy to support a fellow nurse who takes the plunge and writes a book about nursing, so I said sure.

 

 

 

About the Author

Anthony Langley has been a registered nurse for twenty-nine years. He also has a bachelor’s degree in criminal justice. His interest in nursing started after getting a job as a security officer in the emergency room of a hospital. A male nurse who worked in the emergency room showed him the things that nurses did, which got him interested in nursing.

Anthony Langley

He got his bachelor’s degree in nursing in 1990. At his first job, he started on a medical-surgical unit. He has worked in many areas of the hospital, which include surgical stepdown unit, surgical intensive care, same-day surgery, and the post-anesthesia care unit (PACU) recovery room.

 

 

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COUNTDOWN TO PUBLICATION DATE: THREE WEEKS

This past week I promoted my book.

Monday, after a class I attended on public speaking, I collared a woman who had also attended the lecture as she exited the ladies room. “How will you use the information?” I asked. She told me she had planned to start a class for widows on ways to rebuild their lives. Then in the course of our conversation, she told me she belonged to one of the oldest book clubs—meeting over 100 years. Maybe, I said, you would want to discuss my book and I handed her one of my business cards.

Tuesday, I spent the day at a retreat for my hospital volunteer group. The facilitator was a nurse whose office was located in Chicago. Didn’t I write my book about a clinic I ran in Chicago? And am I not scheduled to give a talk at that clinic early next year? And don’t I need to schedule some more speaking engagements to make that trip worthwhile? So I approached her during a break and asked if she would she be amenable to helping me figure out what venues in Chicago that might be possible?

Wednesday, I spoke with a nurse who organizes the Jersey City Medical Center Alumni Association. Jersey City is my hometown and my first job after graduation was at the JCMC. I accepted an invitation to speak at their 2019 spring luncheon.

Thursday, I happened to be a hospital gift shop. I approached the woman who buys the merchandise and offered my book. I’m still working on that connection.

Friday, I attended the NC State Fair with my longtime friend, Carol.  We met in the second grade at Saint Aedans School in Jersey City, and reconnected when she moved to North Carolina 15 years ago. Carol is in my book. The day before, postcard-size cards advertising my book had arrived in the mail, so I gave her a handful to distribute to her Bunko friends and dropped off the rest at strategic places at the Fair.

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Saturday, again laden with my postcards, I handed some of them over to a friend at lunch. She, too, is a writer and supportive of my book selling efforts.

After lunch, I drove to my monthly writing workshop. I passed the cards out to the women who have heard many versions of my stories over the years.

It is not lost on me that I am fortunate to have a group of friends that encourage, support and believe in me and my story.

On Sunday, I rested.

Countdown to Publication Date: Four Weeks

PrintMy book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers is due to be published on November 6, Election Day. Now isn’t that a bummer? In spite of the competition for attention, I plan to get an announcement out a couple of days before via Blog, Facebook and Twitter. Maybe folks will enjoy a distraction.

This is my first book and my first stab at marketing and publicity. My husband tells me it will be easier with my second book.

Most days, I am frozen with indecision where to put my attention and energy. Not being a detail person only encourages procrastination. I have a large legal pad where I list all I need to do. This is not in any priority order so you can imagine that every time I review it, I break into a sweat. Just last week, I made a time line on an old 18 X 24 sketch pad, noting what I need to do when, and the dates of the events I am participating in. No, I am not using an Excel spread sheet or any other computerized aid. I like the feel of paper in my hands, adding new information with a pen, and the satisfaction of crossing out items.

Somehow, just writing stuff down eases my anxiety.

to do list
To Do List

I am learning things that have nothing to do with writing. Like designing a postcard size advertisement for my book. It took me almost two days to finalize this. I ordered 250 copies and I plan to drop them off at various locations, like the Community Center down the block, restaurants, stores, etc. I will slip one into our Christmas Letter that I snail-mail to friends and family who are not computer savvy. Quiet a few years ago, a young woman stood outside my neighborhood library and handed out flyers announcing her new book. I wonder how many of us who took her handout purchased her book? Not me. But that won’t stop me from distributing my own handouts.

Last Friday, I listened to a webinar sponsored by my publisher, She Writes Press, on tips for public speaking given by another SWP author, Betsy Graziani Fasbinder, from page to stage.

She cited two important skills.

  1. Eye contact: Speak to or connect to one person in the audience at a time for about 3-5 seconds, or 2 short sentences, and then randomly connect with another. Avoid darting or scanning the room.
  2. Silence: Using pause will allow your audience to absorb and remember ideas, feel suspense, and adjust for a new vocabulary. The speaker uses silence/pause to help herself think, breath, and relax.

Betsy had more helpful suggestions. Many I have heard before, but now reminded of these skills, I will take time to hone in on them prior to my taking my book on the road. And that, taking the book on the road, should be the fun part. Or so I’m told.

Four more weeks to go.

Nightingale Tales

My new project involves interviewing my classmates from nursing school. We “older nurses” are dying off. Who will be around to tell our stories?

As I gear up to start this project, I’m educating myself in the art of interviewing. In the meantime, a serendipitous thing happened. Lynn Dow, RN, wrote about her long career in nursing in a new book: Nightingale Tales: Stories from My Life as a Nurse.

Lynn Dow entered nursing school in 1956, three years before I did. She attended the diploma program at the University of Rochester, which like my diploma program at Saint Peter’s School of Nursing in New Brunswick, New Jersey was three years long without any summer vacation breaks. The stories she shares of her nursing school days entertained me the most since my experiences so mirrored hers.

In her book, she reminded me that after a patient went home we had to strip the bed and then wash it. Yes, the plastic coated mattress and exposed metal coil springs were washed by hand. When the bed dried, we made it up for the next patient. There were no housekeepers at this time. Two cranks at the foot of the bed were used to raise up the head or to “gatch” the knees so the patient wouldn’t slide down. Later, a third crank was added that raised or lowered the bed. I remember having black and blue marks on my shins from hitting the cranks that were left on the bed instead of taken off and stored somewhere, like on a window sill.

Lynn recalls when cardio-pulmonary resuscitation was still in its infancy, a surgeon might bypass this effort and “crack the chest.” This rarely was successful. Once when I worked in the recovery room my patient went into cardiac arrest. Her surgeon dragged her off the stretcher to the floor, cut her open and pumped her heart with his bare hands. She was an old woman and I felt at the time he did this for the experience rather than to revive her.

Commonly, student nurses staffed the hospitals because there was a shortage of registered nurses, and students were a cheap substitute. In the third year of school, students were put in charge of a ward on the evening or night shifts. Lynn reminds the reader that the student nurses were “teenagers, too green to realize the extent of our responsibilities.” Sometimes the students worked a “split shift,” covering baths and meds in the a.m. and returning to help with dinner trays and get the patients ready for bed in the evening. Before I graduated from nursing school this “abuse” of student nurses was no longer allowed.

Nightingale Tales goes on to cover Lynn’s long nursing career and is filled with educational information and surprising vignettes. While I am especially glad she shows us nursing in the “olden days,” her book also depicts the advancements in current nursing practice. But she feels that possibly “the nurturing aspect of nursing has given way to technology.”

Read her book and decide for yourself.

Don’t Question the Doctor

My friend Lois and I were talking on the phone the other day. We both graduated from diploma nursing schools in the early 60s. It was a time when the nurse was considered the “handmaiden” of the physician. We played the Doctor-Nurse Game* and even stood up when a doctor entered a room. Feeling powerless to confront their authority, not surprisingly, caused us to harbor much resentment towards the medical profession over our long nursing careers.

I told Lois that my volunteer work at a local hospital has exposed me to the improved interactions between nurses and physicians. Of course, having more female physicians has leveled the playing field somewhat and the emphasis on “team” encourages the professionals to respect and work together to care for the patient. I have fresh insight into the challenges physicians face in the health care delivery system that restrict their practice and autonomy. While I do feel more sympathetic toward physicians, I cannot forget the unbalanced relationship nurses once endured.

 

Here is an example from Lois’ book, Caring Lessons.411isrlw3gl-_ac_us320_ql65_

One afternoon while making rounds, I dashed in to see, Mr. Barnes, my last patient, in 236-1, the triple ward next to the nurses’ station. He smiled when he saw me. “I’m going out for dinner tonight. Dr. Jericho is picking me up at five.”

“Oh? I didn’t know. He didn’t tell us at the desk,” I said, scanning his Kardex card in the vertical file positioned on my left arm. “I’ll check on it.”

Back at the nurses’ station, I checked the doctor’s order sheet for Mr. Barnes. Hospital policy dictated that patients could leave hospital grounds only with written orders from their attending physician. Dr. Jericho was not the attending physician; he was a personal friend. And there was no written order.

I faced a potential explosion. Dr. Jericho’s capacity to be short-tempered was well-known to the nursing staff.  We’d each had our experiences. None of us liked it, but we felt powerless to do anymore than endure. And I didn’t need the problem right then: I wanted to give report on time and get home on time, once.

I dialed his office. “Hello, Dr. Jericho, this is Mrs. Roelofs on Hall Two. Your friend, Joseph Barnes, told me you were picking him up for dinner.” I swallowed hard and took a breath. “I see no written order covering this leave. I’m calling to see if you’ve run this by his attending, Dr. Acorn.”

He barked into my eardrum. “I don’t need to check anything out with anybody. Do you hear me? It’s none of your business….who is this again? What’s your name?”

“Mrs. Roelofs. Head nurse. Hall Two.” I forced my voice to sound strong.

“I’m coming right over to clean your clock,” Dr. Jericho yelled into the phone.

My head and heart spun wildly into one big tuft of fear that settled in my throat. I raced to a friend working on the ward at the other end of my floor. We schemed to hide me on that ward when Dr. Jericho arrived. Then we stationed lookout nurses. Minutes later I got the message. I ducked into Room 214, a five-bed room on East, and hid behind curtains drawn around a vacant bed. When Dr. Jericho arrived, my cohorts told him I was off the floor on an errand. He strode into my nurses’ station across from Room 201, parked himself on my desk chair, and bellowed, “I’ll wait.”

When I was a student nurse a few years before, I had scrubbed to assist Dr. Jericho in surgery. He became irritated with something and kicked a metal wastebasket across the room. Anesthesia saved the patient from being startled off the operating table. However, my nerves, as a novice, vibrated with the intensity of the metal clanging against steel and tile. Now my nerves were vibrating once again.

Suddenly, my friend peeked around the curtain, wearing worry on her face. “He won’t leave until he sees you. He’s camped out. Slicked back hair, black suit, green paisley tie, and all. You better come.”

I returned to the utility room on my ward with its steel cabinets, stowed commodes and IV poles, soaking instruments and thermometers, and corner hopper – a large square toilet-like bowl for rinsing bedpans. Standing in the doorway to the adjacent nurses’ station, I said as confidently as possible, “Dr. Jericho, I’m back. I understand you want to see me?”

Dr. Jericho launched to a standing position. “You bet I do. Who do you think you are to question what I’m doing? To tell me I need a doctor’s order to take my friend out for dinner?” His words torpedoed through the nurses’ station and up the ramp to pediatrics.18064403-angry-doctor-in-glasses-with-notebook

He stomped toward me. I backed away, inch-by-inch, until I was flush with the hopper. One more step and I’d plop into hopper water. I was trapped. Only the smothering smells of disinfectant separated us. “It’s my responsibility to see that hospital policy is followed, sir,” I said. My breath stopped momentarily.

“Who are you to tell me what hospital policy says? You, young lady, are never to question me again. Do you understand?”

His words slapped my face like sleet on a winter walk. I could have punched him – he was close enough – but I thought better of it. “Yes, sir.” I held back a salute that he seemed to demand. He turned, clicked his heels, and marched out, as if on a military drill.

My meds nurse, LPN, and aides crowded into the small nurses’ station. “What happened? What’d he say? I’ve never seen him so mad. At least not this week.”

“Oh, the usual Dr. Jericho stuff. Nothing new.” I said, trying to sound nonchalant with a heart rate of over a hundred.

Reaching for the desk phone, I glanced at a list of phone numbers and dialed Mr. Barnes’ attending physician. He gave me the order. Why hadn’t I called him in the first place?

I determined never to let a doctor’s behavior intimidate me again.

Caring Lessons: A Nursing Professor’s Journey of Faith and Self, Lois Hoitenga Roelofs, 2012, pp 49-50

 

 

* Doctors and nurses: new game, same result

Mark Radcliffe, deputy features editor

BMJ. 2000 Apr 15; 320(7241): 1085.

“In the beginning the relationship between doctors and nurses was clear and simple. Doctors were superior. They had the hard knowledge that made ill people better. The nurses, usually women, were good but not necessarily very knowledgeable. They were in charge of folding pillowcases and mopping brows. . . .

In 1967 Dr Leonard Stein first outlined the doctor-nurse game. He said that the interactions between the two were carefully managed so as not to disturb the fixed hierarchy. Nurses were bold, had initiative, and were responsible for important recommendations. While being bold, however, they had to appear passive. In short, nurses were able to make recommendations as long as they made it look as if they were initiated by doctors. So the nurse was responsible for the wellbeing of her patients and the nourishment of the doctors’ sense of professional self.”

FEAR OF TREES–REVISITED

I am taking a break from writing about nursing…

The devastation Hurricane Sandy caused this past week on the east coast has reinforced my fear of trees. I have resurrected a column I wrote that appeared in the Chapel Hill News on June 27, 2007.

LIVING IN THE FOREST WITH MY FEAR OF TREES

My mother never trusted cats. “They’re sneaky,” she would say. “They’ll lie on a baby’s face and suffocate her. They’re not trustworthy.” If my mother had known trees, she would have warned me that they were sneaky too. She would have said that they could fall down on you, crush you to death. They are not trustworthy. But Mom lived her adult life in an apartment in the city. There was one tree in our backyard that Mr. Bruno, our landlord, cut down and then cemented over its roots when I was ten years old. I never missed that tree.

A few years back, when my husband and I lived in DC, a tree slammed on top of a woman’s car as she drove home from work amid a thunderstorm, and beheaded her. The woman was my age. I drove down the same street going to work. From then on I felt in awe of trees. They were powerful and intimidating and untrustworthy.

We lived in subdivision with Bradford Pear trees lining the roads. One spring, as I looked out of my living room window, I watched a Japanese couple taking photos of each other under the white blossoms of the pear tree in front of my townhouse. Why weren’t they down in the tidal basin under the Cherry Blossoms?

Even lovely, modestly tall trees were not to be trusted. The following winter the beautiful Bradford Pear trees were covered with ice from an untimely storm that left us without electricity for five days. Before the ice could melt, the pear trees began to self-destruct. The frosty branches snapped off. One fell on a parked car and totaled it. Other branches lay scatted on sidewalks and roads like so many land mines. The homeowners association voted to replace the dangerous Bradford Pear trees the following spring at an additional cost to each homeowner. Before we had to dip into our pockets, my husband and I moved to North Carolina.

We fell in love with a frame home surrounded by large oaks. I failed to remember my tree phobia. But the trees didn’t let me forget their mischievous alter egos.

In 2003, we came home from a wedding in California after Isabel blew in and out, delaying our arrival. As we steered the car up our driveway, a leafy bouquet lay over the top of our home. Luckily, the tree split in two so only half of the heavy eighty-foot oak crashed into the ceiling of our second floor bedroom.

After we moved our bedroom down to the first floor, the sinister oaks, pines and dogwoods began closing in on me. I worried that one evening, while I sat out on the deck reading a novel, a mild mannered maple would drop a branch on my head.

I suggested that we look for a condo in the city. Not enamored with the side effects of trees—raking leaves, cleaning gutters, and gathering fallen limbs from the driveway—my husband agreed to explore this. We trekked to each grand opening of a new condo building, and even bought two ten-dollar tickets to attend “Live in Downtown Day.”

Then late one afternoon in early spring, my husband and I sat out on the deck of our home. We sipped Merlot and discussed the merits of leaving our 2,000 square foot home for a cozy condo half that size loaded with a high monthly association fee. The tall oaks blocked the glare of the setting sun while the squirrels scampered up and down their trunks. Two hummingbirds buzzed over our heads, fighting over the rights of the feeder that hung from a branch of a birch tree.

Gradually, I began to realize that trees had a gentle side, too. I won’t deny when the winds pick up and the oaks sway overhead, I wish we had a root cellar to hide in but in the meantime, we’ll stay in our forest surround. And we’ll adopt a cat.

Writing the Book

I’m writing a book. I’ve been writing this book for the past five years. Longer if you count the time I worked with a friend to co-author a book of nursing tales until I knew I had to take this journey alone. Add the amount of time it took for the book to take form and we’re talking ten years. There have been many renditions. It started out as a chronological account of my nursing career. Then it morphed into a story about a particular job I had. I added more about my immediate family. My mother ambled into the book complicating my theme and opening old wounds. I changed the book from past tense to present tense and back to past tense again. I’ve had many more working titles than I can remember. Over the years I paid large amounts of money on writing classes and workshops and to consultants to look over my work only to disregard what they recommended. The book remains incomplete.

I don’t believe any of my efforts were worthless. In fact with each rendition of my book, I grew into a better writer. But now enough is enough. I am ready to declare what this book is really about and proceed to complete the manuscript. That’s the scary part. Maybe it’s the real reason it’s taken so long to be done.