This was originally written on February 13, 2018 upon learning of the tragic death of a coworker and close friend, Kristen Patterson. May she always be resting in peace. She definitely is in a better place, leaving from a difficult, abusive relationship.

"My friends, I want to share with you something. Often us nurses take on alot. Sometimes we need that to feel fulfilled.

But what happens to us nurses who are there for everyone else. Who is there for us? Please know, nurse or not...when you feel overwhelmed, stop. And call one of us. Call a hospital. Call a police department. Call a stranger.

Our circle of nurses just got smaller this morning as one of our very adorable "sisters" decided she reached her breaking point, and for the brief miniscule of a second it took to pull the trigger of her gun, felt she had no where else to go.

We are all devastated as this very independent mother of three young kids allowed her heart to be broken enough to use that second to take her own life, even after reaching out to us with a text message she will never reply to.

Please, please. Recognize this miniscule of a second. Hold on to each other. Love each other. And know how much you mean to those around you that will never share funny stories with you again.

Sorry if I'm rambling. A good friend ended her young, newly wed life this morning. Unbelievable."

This was originally written on February 13, 2018 upon learning of the tragic death of a coworker and close friend, Kristen Patterson. May she always be resting in peace. She definitely is in a better place, leaving from a difficult, abusive relationship. 

"Although professionally trained on death and dying, when it hits home I am never, ever going to be trained enough. We will all be going through this together. Many of you are worried about me. So am I. But this is where I excel.

Here are some helpful tips on grief. It doesn't have to be specific to death. Any loss or change that causes us grief, sadness, loss.

Elizabeth Kubler-Ross,an Arizona native and hospice professional,wrote about the following. I urge all of us to read it, live it, experience it, and share it. Be strong. She was.

The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief ‘s terrain, making us better equipped to cope with life and loss. At times, people in grief will often report more stages. Just remember your grief is an unique as you are.

DENIAL

Denial is the first of the five stages of grief. It helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle. As you accept the reality of the loss and start to ask yourself questions, you are unknowingly beginning the healing process. You are becoming stronger, and the denial is beginning to fade. But as you proceed, all the feelings you were denying begin to surface.

ANGER

Anger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal. There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing. The truth is that anger has no limits. It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, “Where is God in this? Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. At first grief feels like being lost at sea: no connection to anything. Then you get angry at someone, maybe a person who didn’t attend the funeral, maybe a person who isn’t around, maybe a person who is different now that your loved one has died. Suddenly you have a structure – – your anger toward them. The anger becomes a bridge over the open sea, a connection from you to them. It is something to hold onto; and a connection made from the strength of anger feels better than nothing.We usually know more about suppressing anger than feeling it. The anger is just another indication of the intensity of your love.

BARGAINING Before a loss, it seems like you will do anything if only your loved one would be spared. “Please God, ” you bargain, “I will never be angry at my wife again if you’ll just let her live.” After a loss, bargaining may take the form of a temporary truce. “What if I devote the rest of my life to helping others. Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements. We want life returned to what is was; we want our loved one restored. We want to go back in time: find the tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only. Guilt is often bargaining’s companion. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain. We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt. People often think of the stages as lasting weeks or months. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one.

DEPRESSION After bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss. We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all? Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of. The first question to ask yourself is whether or not the situation you’re in is actually depressing. The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual. When a loss fully settles in your soul, the realization that your loved one didn’t get better this time and is not coming back is understandably depressing. If grief is a process of healing, then depression is one of the many necessary steps along the way.

ACCEPTANCE Acceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case. Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it. It is the new norm with which we must learn to live. We must try to live now in a world where our loved one is missing. In resisting this new norm, at first many people want to maintain life as it was before a loved one died. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact. It has been forever changed and we must readjust. We must learn to reorganize roles, re-assign them to others or take them on ourselves. Finding acceptance may be just having more good days than bad ones. As we begin to live again and enjoy our life, we often feel that in doing so, we are betraying our loved one. We can never replace what has been lost, but we can make new connections, new meaningful relationships, new inter-dependencies. Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve. We may start to reach out to others and become involved in their lives. We invest in our friendships and in our relationship with ourselves. We begin to live again, but we cannot do so until we have given grief its time."

A group of graduates, well established in their careers, were talking at a reunion and decided to go visit their old university professor, now retired.

During their visit, the conversation turned into complaints about stress in their work and lives.  Offering his guests hot chocolate, the professor went into the kitchen and returned with a large pot of hot chocolate and an assortment of cups - porcelain, glass, crystal, some plain looking, some expensive, some exquisite - telling them to help themselves to the hot chocolate.

When they all had a cup of hot chocolate in hand, the professor said,

"Notice that all the nice looking, expensive cups were taken, leaving behind the plain and cheap ones.  

"While it is normal for you to want only the best for yourselves, that is the source of your problems or stress.  The cup that you're drinking from adds nothing to the quality of the hot chocolate.  In most cases it is just more expensive and in some cases even hides what we drink.  

"What all of you wanted was hot chocolate, not the cup; but you consciously went for the best cups...and then you began eyeing each other's cups.

"Now consider this: life is the hot chocolate; your job, money and position in society are the cups.  They are just tools to hold and contain life.  The cup you have does not define, nor change the quality of your life.

"Sometimes, by concentrating only on the cup, we fail to enjoy the hot chocolate God has provided us.

"God makes the hot chocolate, man chooses the cup.  The happiest people don't have the best of everything.  They just make the best of everything that they have."

“It's not what happens to you that determines how far you will go in life; it is how you handle what happens to you.” —Zig Ziglar

The following is a great story. A story we can all relate to. Of course, it's just that. A story. But it has a great moral. One that we can all use. You see, life is full of wells. And farmers. These can also be called depression and anxiety. Some people, like the farmer, will want to keep you in the well of depression. But like a well, depression is full of darkness, sadness, and loneliness (unless you fall in with your Bestie!😁). Every grain of sand can feel heavy on your shoulders, until one day you decide you aren't going to let depression and anxiety keep you down.

Yes, it's okay to get depressed. Its even alright - and normal - to feel anxious at times. What's NOT okay is to stay there. To live in a well of darkness. 

I have battled depression and anxiety for most of my life. As far back as I can remember. Some how, some way, I allowed someone to  throw a lot of dirt my way.  One day I made the decision not to take it anymore. Life is so much brighter when you see the happiness we were meant to see. 

Many people are like the farmer in this story. Be the donkey! 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"One day a farmer's donkey fell into an abandoned well. Terrified, the animal cried for hours as the farmer tried to figure out what to do. Finally, he decided the animal was old and impossible to retrieve. He realized the well needed to be filled to prevent future losses. So he invited all his neighbors to help him.

They all grabbed shovels and began to throw dirt into the well. At first, when the donkey realized he was being buried alive, he cried horribly. Then, to everyone's shock, the donkey quieted down. A few shovel loads later, the farmer looked down the well and was astonished at what he saw. With each shovel of dirt that hit the donkey's back, the donkey would shake it off and take a step up. As the farmer and his neighbors continued to throw dirt on top of the animal, he would shake it off and take another step up.

Soon everyone was amazed as the donkey stepped up over the edge of the well and happily trotted off!

Life is going to throw dirt your way and attempt to bury you. However, no one ever gets out of life's wells by giving up! Shake the dirt off and take a step up!"

Below is a great article I found while looking for information to write about.  My comments will follow, "Want to Be Happier? Science Says Buying a Little Time Leads to Significantly Greater Life Satisfaction."
By online contributor Jeff Hayden, @jeff haden

Buying things won't make you happier. But research shows that buying time can, as long as you do it the right way.

In 1930, the influential economist John Maynard Keynes assessed how technological and economic advances had reduced the number of hours the average person worked. He predicted that within two generations, most people would work only three hours a day.

Working hard wouldn't be a problem. Filling all that free time would, for most people, be the problem.

While Keynes got a lot of things right, he swung and missed on that one. Technological advances have not freed up the average person's time. Neither have broader economic advances.

Nor has increased wealth. In fact, some studies show that the more money people make, the less time they think they have.

Add it all up, and money can't buy you happiness.

Unless, purposefully and consciously, you use a little money to buy a little time.

In a 2017 study published in Proceedings of the National Academy of Sciences, researchers surveyed thousands of people who sometimes paid other people to perform tasks they didn't enjoy or didn't want to do. Like mowing the lawn. Or cleaning the house. Or running errands. Stuff they needed to do, but didn't particularly want to do.

Unsurprisingly, people who were willing to spend a little money to buy a little time were happier and felt greater overall life satisfaction than those who did not.

Correlation isn't always causation, though. Maybe the people who spend money to buy time are happier simply because they have the money to buy time?

Nope. While relatively wealthy people who spent money to buy a little time were happier than relatively wealthy people who did not, people at the bottom end of the economic spectrum who spent money to buy a little time were happier than those at the bottom end of the economic spectrum who did not.

No matter how much you make, no matter how wealthy you are, buying a little time makes you happier. (With a couple of catches; more on that in a moment.)

Just to prove the causation point, the researchers conducted a further experiment. One week, participants were given $40 and told to spend it on any item or items they chose. The only restriction was that they had to use the money to buy "things."

The next week, participants were given $40 and told they had to spend it on freeing up time. Cleaning. Maintenance. Delivery. Paying someone to do something they didn't want to do so they could use that time to do something they did want to do.

You've already guessed the result: When the participants bought time instead of things, they felt happier, less stressed, and more satisfied.

There is a catch. The researchers found that "spending too much money on time saving services could undermine perceptions of personal control by leading people to infer that they are unable to handle any daily tasks, potentially reducing well-being."

Granted, most of us can't afford to spend so much money buying time that we feel inadequate or incapable. But still: Making a conscious decision about which tasks to occasionally farm out is key.

And why you decided to farm out that task. If someone always cuts your grass, then you've likely made that your new normal. You probably still feel too busy. You probably still feel time is scarce.

The key to buying time is to consciously decide how you will use the time your money freed up. Buying time will make you happier only if it feels intentional and purposeful--not because you don't have the time, but because you want to use the time you have differently.

Instead of cutting the grass, you might decide (again, to make this work you have to decide) to spend the time with family or friends. Or working on that side project you can't seem to get to. Or reading. Or working out.

In short, doing something you enjoy--doing something you want to do--with the time you bought.

That's when money can buy you a little happiness.

No matter how much you make.

My first thought about the title to this article was, "Is that really possible?"  For the first time in my life I am making money that I've never seen before, and it seems to go almost as fast as I'm used to.  However, I have been buying a little time, and I can attest to the fact that yes, buying that little time gives me a little more freedom to do what I want.  

As a single nurse with two jobs (one very part time, but..), four indoor dogs and a home to maintain, I have little time for fun.  Ive been asked on more than one occasion, "when do you sleep?"  I try to stay busy with house cleaning, home projects, yard projects, and crafts.  But I DO sleep.  Alot. 

Since I am now making more money than in the past, I have decided to "buy some time".  I was paying to have my grass cut last year but that didn't last too long.  I also had my sister buy me some time with unpacking the moving truck, which was a Godsend. 

A few months ago, I advertised to see what it would cost to clean my house.  I'm skeptical about hiring a cleaning company, but I really do need the help sometimes.  I'd love one to come in and just do a major clean (windows, dust junk, etc.) however THAT doesn't need to be done often.  So, I chose a young high school girl to come weekly to do the simple stuff.  She also has a twin brother who would like to make some money as well, so I give him the more "dude" work.  However, he usually causes me more work picking up after him.  Seems he's never touched a lawn mower, a tractor, a screwdriver or paint brush.  His ability to follow directions the first time is also lacking attention.  But they are only 16, so I am patient, kind and generous - they each get $40 per trip.  

Buying time allows me to rest, to play in the yard, to sew.  It gives me some company since I don't leave them alone, and I can choose what we will be doing at any given time.  Last week they painted my porch floor.  I am doing the yard work myself this week.  Because I have time.  And I'm grateful that it IS, possible.

(This article was republished with permission from SCRUBS Magazine.)

We asked our Funny Nurses family to fill in the blank after “You know you’re a NURSE when…” and we got some pretty great responses!

You know you’re a NURSE when…

1. When you sign the credit card receipt at the store…and everything else with “RN” – Meighan H.

2. When you can write a complete paragraph in nursing shorthand and it makes perfect sense… to any other Nurse. Conversely, it is an unbreakable code to anyone else. – Michael F.

3. When you inhale every meal you eat. Even at home literally hardly any chewing. #aintnobodygottimeforthat – Gabi C.

4. When washing your hands before using the toilet. Scrub Nurse FTW! – Makis T.

5. Use sterile technique to open a stick of butter. – Chrissy B.

6. When you make your bed with hospital corners. – Nadine G.

7. You know you work night shift (rotating) when you drive home and sit at a stop sign waiting for it to turn green. – Kay J.

8. Being a male nurse and getting every patient questioning your orientation or calling you doc. – Carl S.

Once upon a time, there was a precious woman named "Doris".  I was fortunate enough to meet Doris during my time as a hospice case manager in Arizona.  Doris was an elderly lady who battling cancer and unfortunately was not winning this battle.  Patients who are shown to not be winning this type of battle are often referred to hospice to receive health care in the comfort of their home.

I remember one afternoon, after visiting with Doris and completing my assessment, I was asked to sit at the dinner table with her husband, her daughter and son-in-law.  As is often with large families, children and other relatives come in from out of town not expecting to see what they are now seeing, not expecting to feel what they are now feeling, not prepared for what is to come.

This was a long Q & A session, when the subject of Doris's birthday came up.  I remember asking something such as, "what can we do for Doris for her birthday?"  It's quite possible I'd known from conversations with this beautiful woman that she's always wanted a cat.  She had never been able to have one because her husband "won't let me."

So I broached that subject.  The daughter agreed, said "yeah mom has always wanted one, but dad didn't want one."  Then we all looked at "dad", who was sitting solemn in his own worry and guilt.  Somehow he was finally agreeable to this possibility.

I am always saddened when I can't remember better details, but I sure remember how this story turned out.

That evening, I made several calls to shelters and even the animal control center and humane society.  Some shelters were not happy about the idea of "loaning" a cat, one that is already been turned in and forced to live in a cage, not knowing how today will end.  However, the Animal Control location in my town of Peoria, AZ was so thrilled to be able to help provide a dying woman with her last wish.  I then called the family back and told them we had a surprise for Doris's birthday tomorrow, and I'd be back later that night.

The shelter was still open so I rushed over to talk to them and pick out the "one".  The one that would bring smiles to a sick woman's face.  The one that would bring a smile to my face, too.  The shelter staff and I went to the area where the cats were kept, and sat and watched - to see which one may take to us, which one seemed to be the "one".  There she was.  We found her.  Lydia was a beautiful long haired black and white female cat.  She had been at the shelter long enough to not be withdrawn to her cage.  

That evening I took Lydia home with me and prepared her and her goodies for her new role as guardian of the angel.  The shelter even gave me some food for her to travel with for this trip, however long the job was going to be. I had stopped at a pet store and bought all the remaining necessary supplies.  I was so excited.  Lydia was such a good car companion.  I think she knew she was going to a wonderfully safe yet sad place.

At about 830 that evening, I pulled up to Doris's home.  She'd been asleep for a little while now, but .... I took Lydia in to meet the family.  She didn't make a peep.  The family was pleased, even 'dad.'  

**There is such a warm, fuzzy feeling that one gets when able to do these little things (little to me, not so little to the recipient).

After bringing in the rest of the supplies - food, dishes, litter box, toys, etc., we quietly went in to Doris's room and gently woke her up.  She was surprised yet concerned to see me there during the evening.  When someone is bedbound and dying, there is no concept of time, only day and night.  She'd not seen me there when it was dark.  I bent over and kissed her forehead, wished her a happy birthday, and told her we had a surprise for her.  Her husband walked into the room, carrying Lydia, with the rest of the family following.  Lydia was placed across Doris's abdomen.  Doris cried.  I know I did, too.  We introduced her to Lydia, her first ever cat, as she has always wished for, for her birthday.  

Doris's condition continued to deteriorate pretty quickly, but she was able to remain lucid enough to enjoy Lydia for about a week.  The family reported that Lydia never left her side, except for potty and lunch breaks.  Lydia provided that sweet woman with the best comfort during the last days of her life.  After that week, Doris had to be transferred to the hospice inpatient unit for symptom management.

Upon her passing, the family discussed what was to become of Lydia.  I knew I would have to take her back to the shelter, as her job was done.  However, the family had a surprise for ME!  They decided that Lydia did such a great job, that they were going to find a permanent place in their lives for her.  

When I called the shelter to let them know, they were excited, too! All the family had to do was complete the adoption application, but they were expecting to be leaving to their home in Illinois the next day.  What do we do?  Doris's daughter and I drove to the shelter only to find that they were closed that day!  What do we do?  ...

Most shelters have staff around the clock for cleaning, feeding and caring for the animals, so we knocked on the door and happened to find some of that staff!  They were so gracious, so attentive to our plight, so warm and welcoming.  Even on a closed day.  They helped Doris's daughter complete the adoption process, and thanked her for letting them help with her mother's last days.  It was US who then thanked THEM for making it happen.

A short time after the family returned to their 'normal' lives, I received a letter from Doris's daughter.  They loved Lydia.  And Lydia loved them.  Except...living in Illinois, they changed her name to Peoria.  It was where mom lived, it was where the shelter was, only in Arizona.

This story has stuck with me for a few reasons.  Mainly for the birthday surprise that I was able to make happen.  But Doris was also my mother's name.  And this Doris was the same age as my mother when she passed away.  They shared the same awful disease. 

There was another part of this story that also stuck with me.  Doris spent her last 4 or so days in the inpatient unit.  We transferred her there, because according to her symptoms, she should have died long before.  We often have to rule out the comfort measures, her symptoms, etc. to get a better idea of her transition time.  She was defying all of them.  What was she waiting for?  All family was present.  She just was holding on.  What for?  Some time after her death, her son said, "mom had never been baptized, but always wanted to be.  And mom did NOT want to die at home.  When we figured that out, mom was baptized by her pastor, and within hours of that process, she slipped away as peacefully as we had hoped."  

This experience was one of many.  As a hospice nurse for the first 7 years of my new nursing career, I witnessed many a soul pass on.  I held the hand of as many as welcomed me.  Most ready, some not.  But not all of them stuck with me and warmed my heart like this one did.  

I continued to receive Christmas cards from Doris's daughter for a few years afterward, each with an update on Peoria!💔 

Peoria lived happily ever after!

(My thoughts about laughter will follow later.  With Love.❤ )

5 Healing Benefits Of Laughter & Humor When You’re Stressed Out - Dr. Alicia H. Clark Expert Health And Wellness 07/09/2020

They say laughter is the best medicine, and it's true.

Everyone is navigating novel situations because of the pandemic. Understandably, these new situations — working from home, homeschooling, working from home while homeschooling — are causing significant stress and anxiety in many of our households.

Among a myriad of stress and anxiety management tools, my favorite is laughter.

Humor heals, as long as you free yourself to tap into the benefits of laughter. 

A friend’s videotaped reaction to the three-week extension of the stay-at-home order was a priceless gift to her social media friends a few weeks ago.

She had gotten the giggles, and when I tripped across her video, I did too.

The laughter was unexpected and cathartic. Hers was the contagious kind of laughter that both engulfs and releases tension all at the same time, leaving you feeling happier, connected, and just better.

It was good!

It reminded me of how important laughter can be when it comes to managing stress and building resilience, no matter the crisis you face. And there are many good reasons why this is.

Laughter is as powerful an emotional release as crying is in its cascade of biological helpfulness.

Here are 5 healing benefits of laughter and humor when you're stressed out.

1. Laughter takes your mind off the situation.

Laughter has powerful distracting benefits. A sense of humor can heal.

Looking for the humor in a situation and even allowing yourself to laugh can be a strong catalyst for coping, managing anxiety, and be protective in building resilience.

As a bonus, when you share your laughter and humorous take about a common difficulty (as my friend did in her video), you help others take their minds off the situation, too.

Your humor heals not only you, but those who can appreciate it.

2. Laughter triggers a biochemical reaction that eases discomfort.

What's especially interesting is the relationship between the biochemistry of anxiety and laughter.

The amygdala is a very small area of the brain and is at the center of our threat response or fight-or-flight response. Yet, the amygdala is also involved in laughter.

While there's much more to learn about the biology of laughter, it can be particularly effective when it comes to releasing tension and stress, as well as tolerating anxiety and pain.

3. Laughter leads to greater health.

Science is strong for laughter’s health benefits.

Laughing increases the production of immune cells and reduces cortisol, the hormone that's chronically high when an individual suffers from long-term stress and suppresses the immune system.

It also lowers blood pressure, antibody levels rise, and the body’s natural anticarcinogenic response accelerates.

Laughter truly is great medicine!

4. Laughter is a strong social glue.

Laughter is a powerful social catalyst. It connects us to others in that it releases the brain’s feel-good chemicals called endorphins.

It is also highly contagious. This makes laughter particularly efficient at building a connection, too.

5. Laughter improves mental performance.

Laughter improves cognition.

Developed by Rod Martin, a psychologist and laughter researcher, the theory explains this phenomenon as the result of an accelerated heart rate, which increases oxygen to the brain.

So whether it’s a favorite rerun of Seinfeld, the latest edition of Some Good News, or one of the top comedy movies of all time, search out opportunities to laugh wherever you can.

Discovering for yourself how humor heals can be a pleasure in itself and is a powerful tool in terms of resetting your mood and boosting resilience.

No matter the crisis, look for ways you can laugh. It will help! 

This is something I wrote in January of this year. Employers always tout, "see something, say something".

In nursing it is always important to do the right thing. But just who is the 'right thing' for? Is it the right thing for the corporate suits (previously referred to as 'hacks')?

Or is it the right thing to do for the pocket book of the insurance company wallet? Is it saving time? Is it the right thing to do for your nursing license and within the scope of your practice? How about this....Is it the right thing to do for the (usually) living, breathing human being within our hands?

Case in point: In 2006, during my first nursing clinical rotation in an Arizona hospital, I was following a young nurse during her early morning medication rounds. Being a nursing student, I looked to her for guidance, as she has more experience here than I. However, with our age gap close to 20 years, I certainly had more life experience than her.

On this round of giving medications, the nurse happened to drop a tablet on the floor on the way to the patient's room. She casually bent over, picked it up, and carried on. "Are you going to still use that pill?", I asked. "Welcome to the real world" she replied. What did we save? What harm could one little, now dirty little pill do?

I learned nothing except for what kind of nurse NOT to be. In another instance, during my final five week preceptorship at another hospital in Arizona I am placed with a few older nurses.

Clearly older, more clinical and life experience (I assume) than I. A young, black, morbidly obese female was assigned to me. I chose this patient because of her admitting diagnosis of "sickle cell crisis", something I'd not yet seen.

To someone who is not of the race or someone who has not experienced this kind of crisis, understanding of the magnitude of pain experienced by the patients is something not to be judged. Rule number one in nursing school.

Pain is what the beholder says it is. This is another story that will stay with me for a while. Anyway...I digress. The patient in a crisis is cranky. Needy. And back again. A morbidly obese patient in crisis is all of that and more. They can't sleep, they can't breathe, they can't get comfortable.

The shift nurses were glad to throw her onto me for a break. She's apparently a "frequent flyer" (more about that in another story) and the nurses were tired of "caring" for her. The more 'seasoned' nurses tend to do this with students. I prefer to give them ones who will teach them something - however this IS what happened here.

So this young lady was always hungry, always thirsty, always in pain. And always on the call light. At one point during my first day, I happened to catch a few of the nurses sporting pig noses on their faces, mocking this young girl. I was shocked. This was highly inappropriate and insensitive. Man, it made me feel bad for the girl, and soon she became my "pet project" and I gave her all the positive attention one could.

I said something to my clinical instructor who advised me to talk to the department manager. I asked both women NOT to say anything to the nurses, that I just needed to "do the right thing". THAT didn't happen, the manager talked to the nurses. That afternoon one of them, a crotchety, gray-haired 'seasoned' nurse backed me into a corner. Said something like "I hope you always stay this positive, and don't get burned out and tired!" She wasn't saying it in a positive, pleasant way. That really set the rest of my rotation there up for failure at best. There have been other instances where I've seen something, and I've said something.

And if you believe that there won't be retribution from the very team that is along side of you during a Code Blue, you're mistaken. It makes for uncomfortable nights, or even for a loss of friendships when you leave the company for doing the right thing. For patient safety I've made calls to State departments, Human Resources, even the Ethics line. All supposedly in the name of confidentiality. It almost always bites me in the ass. So, what IS the right thing to do? Keepin' it on. As an advocate for the patient, I shall.