Nurse Sean (dot) com

It’s cold here! Last time I checked it was -18C (I’m not good at fahrenheit conversions for ll the American folks out there), which is even cold for a person like me who hates heat. However, it gives me a chance to bundle up in my 2006 Canadian Winter Olympics gear which I adore.

I have a couple days off before switching back to nights. I have been working 12 hour days for a months now, and I’m ready to be a night person again! I am tired of hearing that alarm go off at 05:00am. It will be nice to be back to where I feel more comfortable.

I was working in our unit’s high observation room for the last few days. I adore working in there! For starters, we have a 2:1 nurse/patient ratio (the room fits four patients). This means that while working together, we get an incredibly good amount of stuff done for our patients. I wish it was always so good.

The other thing I like about the high obs room is the high acuity of the patients. Some nurses can’t stand unstable patients, but I’ll be honest: the more unstable the patient, the more interesting they are to me! This is the reason I fully plan on moving to the ICU and working toward being on the hospital’s code team.

Speaking of the ICU, I wrote another of my critical care nursing course tests yesterday. This one was brutal. It was renal physiology, which I generally find fairly straight forward, logical, and easy to learn. However, I just didn’t have a lot of time I could devote to studying for the test. I don’t have my results back, but I don’t think I will see a mark above 90% like the other tests; and frankly, I don’t deserve a high mark.

Yesterday, we had a large staff meeting. We’re tired of being chronically understaffed; we’re tired of having patients lining the hallways because administration forces us to take many patients over our unit’s capacity; we’re tired of our incompetent manager; we’re tired of so many things.

We compiled a list of our complaints about our manager and the hospital. Then, we backed up all our complaints with research and numerous personal experiences. We also cited our nursing association’s practice standards. Then, one of us (thank God for her!) stood up in front of about thirty unit staff, our manager, and two of her managers, and listed our complaints and demands.

We called for serious action!

We really didn’t get any. The answer we received was basically, “We here what you say, we believe what you say, we understand what you say, but we have no solution…so sorry. You still need to work understaffed and over capacity.”

The only step forward was the creation of a “unit council” that will meet with the goal of coming up with solutions to our problem. The administrators are pushing us to reform our nursing model. They want to use a much more multidisciplinary approach to nursing.

In this model, nurses would be “case managers” as they described it, and would manage a team of multidisciplinary individuals. Instead of providing direct nursing care, the RN would direct a team of individuals to provide care of patients.

They even suggested adding extra staff to the unit, such as: pharm techs, physio techs, Recreation therapists, and whatever else we could imagine. Their thinking is that we could utilize the appropriate resources to provide well-rounded care to our patients.

I personally a very strong advocate of this style of nursing. When I went into nursing, this is actually what I thought being an RN. That is, I thought RNs were the supervisors on the unit that gave orders to LPN’s and NA’s to provide care to patients. I thought they were the case managers that I just described.

I am always embarrassed to admit that when I started nursing school, I didn’t think RN’s did bed baths, or changed diapers, or toileted patients. Even after the first year of nursing school I was under the impression that we were just learning those skills because we would have to supervise others while they performed them. So, it was a bit of a shock in the second year of nursing school when I came to the realization that these tasks WERE a part of my job.

The major opposition to this approach is nurses who went into this profession because they wanted to do the bed baths, toileting, attends changes. They refuse to let go of these items simply because it’s the part of the job they think IS nursing.

As I’m a recently trained nurse, I was taught that being a RN means working at a much higher level. Nursing, the way I was trained, is about being a leader of a multidisciplinary team focused on implementing a holistic plan of care that cares for the patient both physically, spiritually, and mentally.

I truly believe that a lot of nurse’s skills are wasted! We only use a small fraction of our scope of practice. And the fraction we use is stuff that other professionals can perform. It’s stuff that, were it to be let go of, would allow us to work at a higher, more intellectual level, and (God forbed!) be seen as professionals, rather than blue collar workers.

We deserve a step forward in our profession!

Sorry, that was longer than I intended….

After our meeting, we went out to dinner. It was so much fun hanging out with the folks from work and gossiping. I don’t get invited to a lot of events (every event seems to be a bridal shower or baby shower…no men allowed!), so it felt good to be chummy with my friends from work.

Today, I’m looking forward to getting a small amount of Christmas shopping done. But, I’m not too stressed out about it. I typically enjoy doing my shopping closer to Christmas day. Seriously, it just FEELS more like Christmas when you actually buy your presents around Christmas. Buying everything in August just isn’t the same.

Many times people ask me what it’s like to be a man in nursing. Based on observation and experience, I actually feel fairly negative about the way men are treated by female nurses. So, I am writing this with the understanding that many (most?) people will disagree with how I feel. Hopefully I can start some debate and help open people’s eyes to what may be going on.

1.) Novelty

Men in nursing are often seen as a novelty in the profession of nursing. We are a minority, but rarely seen as equals. We are looked upon as an exotic animal at the zoo that everyone comes to see.

This is felt innocently enough in the very first days of nursing school when the professor inevitably looks out at the crowd and cries, “Oh good! There’s at least five men in the crowd! I’m so excited!”

Sure, it’s not meant negatively at all, and in fact it’s meant as a very positive comment. However, it instantly solidified my status as a very special exception to the norm. Everyone in the class stretched and turned their necks to do their own count of all the men in the class.

“oooooh…look at all the men, there MUST be at least ten of them! I wonder if they’re gay?”

This carried forward over the years. If I missed a class, the professor always knew, after all, as she said, “you stick out like a sore thumb, I always notice when you’re not here!”

Fast forward past school and onto the unit. Nothing has really changed. There’s always little “cutesy” comments about me being a male nurse. People are well meaning, and think it’s great that I’m a male nurse–that’s not the issue. I just wish that occasionally I could blend into the crowd and be a “Nurse” rather than a “Male Nurse.” Or “Murse” as we are frequently called now. *cringe*

And don’t forget, we even have our own novelty toy! The male nurse action figure! I have to admit, I have two of them–people keep buying them for me as presents.

2.) We are your children

For a long time I thought that it was me alone who experienced this phenomenon, but I’ve come to see it happen to other male nurses along the way. In fact, I would love to do some sort of research to confirm it.

The fact is, many of the nurses both young and old treat me as though I’m a four-year-old. I don’t know if it’s social or genetic but often it feels like the female nurses see me (and men in general) as someone that needs to be cared for. It is as though I am another one of their patient.

I am not treated as an adult in the crowd of female nurses, but instead as the child. I don’t get to sit at the big people table on breaks (I’m not invited because the girls want to have their gossip time), I’m not updated on everyone’s social lives (he wouldn’t understand such adult and/or female topics), I need to be helped and guided with every little task as though it’s my first day of nursing school (such a “child” must need help with every little task, right?).

And there’s always that change in voice, “Oh Sean! My little poopsy woopsy, howsy wowsy did that drain dressing go? Does my little smoochy woochy need me to watch him doosy woosy that catheter insertion?”

“uh…no? Why would I?”

OK, that was a bit of an exaggeration.

3.) Not to be trusted!

I feel that men are treated as though they are never to be trusted. As I mentioned with the last point, I looked inward before looking externally–I wondered if it was only me. However, I’ve noticed this as a trend with all the male nurses on my unit.

Nothing I ever do or say is ever to be trusted. EVER. Here’s an example: A couple nights ago, I was caring for a very sick man. My charge nurse took it upon herself to “babysit” me all night with this patient.

“What was his blood pressure?” she interrogated me with?

“70/40″ I replied.

“Did you take that manually?”

“yes”

“Are you sure?”

“Yes…the orders state that they want manual BPs. I’m doing manual BPs.”

“What’s his urine output?” She has a frowny face now. I’m sure I have morphed into her teenage son who has just arrived home late. She’s trying to determine if what I’m saying is truth or lies.

“15cc over the last hour”

“hmmm….that’s low. Are you sure?”

“Yes, I just checked!”

“You better look again before I page the doctor. And take his blood pressure. Make sure it’s manual this time! I can’t believe I have to page the doctor and you don’t have all the information for me.” Now she’s looking disgusted.

I’m of course very upset at this point but decide to be the bigger person. I go and do another blood pressure and check her urine output. On top of this all, she didn’t even ask if I was worried about the patient, or what my assessment of the situation was.

The fact is, the patient’s BP had been about 70/40 with a urine output of about 15cc/h for about two days now. His condition hadn’t changed; I had no desire to page the doctor about this at 2:00am.

When the doctor did call back, he politely said, “thanks for the update, but there’s nothing more I can do as I explained earlier, just continue with current orders.” So, of course, now the doctor’s wondering why I’m such an idiot.

The issue is that this nurse NEVER would have had this conversation with any of the other female nurses. She wouldn’t have asked if it was a manual BP or questioned her urine output numbers.

How about this example: My patient filled her attends with liquid BM. I asked another nurse to come help me out.

As is common with large liquid BMs, it covered her vagina and Foley. I grabbed the cleaning material and start scooping away poop. The other nurse pushes me away and states, “Seansy Weansy! You have to wipe front to back!”

Thanks for the news flash lady; it doesn’t take a nursing degree for even a man to know that (but a child?). Correct me if I’m wrong, but isn’t the point of wiping front to back to keep feces away from the vagina? If the vagina is covered in feces, does it really matter how you get it off? Keep in mind that I WAS cleaning properly (i.e. middle to outside, front to back), but took a few extra wipes to get into the nooks and crannies.

Would she have questioned a female nurse? No, but you can’t trust a male nurse’s level of knowledge, of course.

4.) Male Nurses are Criminals

This is a VERY controversial topic. I have seen it bring nursing forums to the brink of nuclear war. The fact is, patients and other nurses treat men in nursing as though we are criminals–suspicious at best.

Elderly patients often see male nurses as sexual predators. After all, if he wasn’t, he would have become a doctor, right? I have been asked by patients, both nicely and in fits of screaming (yes, seriously, one patient had a temper-tantrum when I walked in the room, before I had even said a word) that I will in no circumstance be allowed to be their nurse.

Female patients can be uncomfortable with male nurses. But why? It’s because we’re suspicious, we’re “creepy,” we’re obviously in this profession so that we can get to see women naked! Free boob views!

When asked why they have no problem with their male doctor seeing their body, the typical reply is, “They’re a doctor, it’s just different!” Yes, nurses are some of the most trusted people in the world–unless you’re male.

Male nurses (and doctors) are often required to have a chaperone when performing “female” interventions. The message this sends is that all men are capable of being criminals, so better safe than sorry.

I will not apologize for my belief that it should be illegal to require a chaperone when men are performing procedures. It is blatant sexism! Until women require chaperones for the same procedures, I will not budge. I will not tolerate indirectly being called a criminal needing to be “babysat” (yes, we’re back to the child thing again).

Next time a female nurse has to put a Foley in a 90 year old male patient, I better be there! What if she decides to start fondling him?

The only sexism I tolerate is religious. Islamic women often refuse to have a male nurse help with “female” care. They can’t help what religion/culture they are; it’s how they were raised. I had a patient the other day: every time she had to go to the bathroom I had to call a nursing aid to help her out. Her husband, son, and I all stood in the hallway with two doors between the patient and us, waiting. No man is allowed to see her like that.

And I used my words carefully. I don’t like this form of sexism–I tolerate it.

5.) Social Outcasts

The men on my unit are never invited to the unit’s social events. The main reason for this is that their seem to only be the following occasions for social events: Bridal showers, weddings, baby showers, and my favorite: “girl’s night out.”

When the nurses on my unit want to party, they want to do it with the other girls. Every day I’m inundated with facebook pictures of all the girls socializing. I come into work to hear all about the fun night they had celebrating.

Have you ever been that one person that is never invited to anything? That always feels left out of the conversation because you weren’t there when everyone else was? Have you ever been that person that wants to be included, but never is?

If you’ve ever been that person, I don’t think I need to say more…

7.) Male Nurses are Lazy

This one seems to have hit other men I work with even more than me. However, I’m pretty sure I’m on the receiving end of this stereotype as well. I truly believe that male nurses are often seen as being lazy.

I think this stems from the fact that the men I see entering nursing tend to be “type B” personalities, while women that enter the nursing profession tend to be “type A” personalities.

Often, I feel that coworkers resent this laid back persona that men often bring to the nursing unit (often they claim to love it). I have seen looks of disgust when a male nurse is seen socializing, making a joke, or finding ways to have fun at work (yes, it IS allowed).

Men (in my experience) are better able to let go of the little things–to avoid sweating the small stuff. As a result, I have seen male nurse’s performances critiqued and nit-picked when they were certainly not deserving. On the flip-side, females are just assumed to have done a perfect job–much less questioning or their abilities.

Fortunately, as I said, I’ve rarely experienced this myself (but of course, it occurs behind our backs, so I wouldn’t know).

8.) Never good enough

This goes along with the point that men are never to be trusted. But I simply wanted to focus it to the following point: when women have spoken about working in male dominated professions, they discuss having to be twice as good as men just to get half the respect.

As male nurses, I feel we need to work twice as hard and have twice as much knowledge in order to receive half as much respect from our female coworkers as the other female nurses do.

******

On a final note: I know this is a very personalized set of experiences and I’m generalizing to the entire nursing profession. I’m aware of this and the inherent flaws of doing so. I could just as easily do a post about what is great about being a male nurse; however, I wanted to share what I felt were the negative aspects.

I will also say that this rant follows a particularly tough night where every issue above was felt. I have decided to make personal changes in how I communicate, project myself, and react. This post was not made in a vacuum, but is most certainly in response to personal experience. But there is nothing I have stated above that I haven’t seen happen to other men in nursing.

Please feel free to completely disagree and argue my points. However, I do ask that you be respectful.

I’ll be honest: I really don’t have anything exciting to blog about. It’s just been one of those weeks that has been going a little TOO smoothly. Yes, I’m waiting for the other shoe to fall–did I get that saying right?

I’m back on night shifts, which is a definite pleasure after a month of working day shifts. I was at the point where I’m sure I would have screamed–loudly–and possibly cried if I had to work one more day.

The issue is that our day shifts are incredibly short-staffed. When you come to work in the morning, you have a pit in your stomach because you can’t help but be completely anxious about what you’re getting yourself into. Rarely do we have an appropriate assignment, instead having to run around taking care of our overcapacity beds (yes, you’re lucky now if you’re in a bed rather than lined up in the hallway on a stretcher). It’s not unusual to have six or seven patients now–which is completely dangerous and inappropriate.

Keep in mind, CNAs here don’t do vital signs, don’t do glucose monitoring, don’t empty drains, and only help with morning care–rather than be expected to be responsible for it all.

Night shifts are different. Because day shifts are so horrifying right now, everyone wants to work nights. In fact, contrary to the norm, straight night positions are a hot commodity currently. Everyone has requested to work nights! Also, because they are better staffed and less stressful, there are less sick calls.

Night shifts actually feel “safe,” rather than that feeling of impending doom that comes with day shifts. We have time to socialize and talk. We aren’t rushed to get everything done. We feel like normal people in a normal job working at a humane pace.

If it weren’t for night shifts, I’m not sure I would have lasted through my first year post nursing school.