From the Odds and Ends Department

Have you ever watched something on TV, or read something, and thought, Man, I could do so much better than that! You might even be thinking that right now…  Especially if you’ve read more than one of my blog posts.

I mean, all this guy writes about is getting wasted, his slutty girlfriends, and how all of his relationships fell apart! There was that story about his nympho Russian girlfriend, Ivana Sukyurkokov. And his heartbroken Chinese girlfriend, Wat Wen Wong. Jeez, his blog is dumber than putting wheels on a ball! I liked him more when he wrote about crazy people!

And I hear you. Before I started writing my blog, I thought bloggers were people who needed to get a fucking life, man. They were probably people who thought Paris Hilton and Kim Kardashian were the epitome of American society and they all wanted to be Paris-ites, or biffles, or twat waffles with them or something.

I’ve started reading some of the blogs that are out there on the Interweb, and I was wrong about bloggers. Most of them appear to have lives.

Except me.

I’m retired. If I were to write about my day-to-day life now, my blog would consist of restaurant reviews in the Lakeside area, and stories about how much I love my Sleep Number bed®.

And to be honest, I probably liked me more when I was writing about crazy people, too. But those stories are relatively easy to write, and like everything else in life, it’s only when you step outside of your comfort zone that anything meaningful happens. It’s the stories I didn’t want to write that taught me the most about myself. It was the stories that hurt like hell that showed me how far I’ve come.

And how far I still have to go.

And the other thing about writing about my nursing career is not every person I cared for resulted in a story worth telling.  Knife wielding homicidal maniacs were the exception, not the rule, thank God. Most of my patients were never a problem, unlike medical dramas on TV. I’d probably hate being a TV nurse, unless my work partner was the hot nurse with the big tits…

The majority of my nursing career was pretty ho-hum. Mischief was managed. Shit got done. No one died. And that was that. But there were a lots of snippets and moments and oneliners, and if I could patchwork a lots of them together, I might be able to spin a tale or two…

* * * *

I’ve discovered that time management is still necessary once you retire. I certainly have more time to do things I enjoy now, like reading. And because other bloggers sometimes read my posts, I feel a certain obligation to read some of their posts, too. My favorite blogger is a young woman in New York who writes about her struggle to overcome her eating disorder. Her blog is called Beauty Beyond Bones. And while I love her now, I probably would’ve hated her as a patient.

Back when I was a psych nurse in Arizona, there were a couple of eating disorder treatment facilities in the little town of Wickenburg, about thirty miles northwest of Surprise. Remuda Ranch and Rosewood Ranch. She’s never come out and said if she was a patient at either of them, but I’m going to guess she was at Remuda. I hope she doesn’t mind me saying that. I interviewed at both facilities, but decided not to take a position at either one of them. I absolutely sucked at working with eating disorder patients.

Remuda is a Christian based treatment facility. One of the questions they asked me in the interview was did I think the Bible was the sole source of truth. I said no, it wasn’t, and I wasn’t even sure all of the things written in the Bible were true. After my interview, they told me I wasn’t Christian enough to meet their criteria. I told them that was okay. They weren’t the first Christians to tell me that.

A few weeks later they called me back and told me that they had changed their mind about me, and asked if I was still interested in working there. I wanted to say something like, God, you guys must be fucking desperate! But instead I thanked them for thinking of me, and told them I had found another position and I wasn’t available anymore.

Well, it was the truth…

Like most every psychological/psychiatric disorder, eating disorders are caused by a multitude of complex factors, and as with every psychological/psychiatric disorder–except dementia–the successful treatment of anorexia or bulimia depends completely on the patient. If they don’t want to change their behavior, there ain’t nothin’ anyone can do for them once they’re discharged from the hospital.

It’s like alcoholism or drug addiction, only worse. Just as the drinking and chemical use are usually a symptom of a deeper, darker pathology, eating disorders are about far more than food.

Eating disorders are incredibly difficult to treat, mostly because eating disorder patients are the spawn of Satan. I mean that in a Christian way. They are sneakier than a ninja. They can vomit silently so they can purge without anyone knowing. They stockpile food so they can binge feed when no one is looking. And if their lips are moving, they’re probably lying.

The other thing I remember most clearly about most of these women, and they were all females, is the majority of them were gorgeous. And that is truly one of the great mysteries that used to keep me awake at night when I was learning how to be a psych nurse. How could someone so beautiful be so fucking miserable?

One of my first posts was about one of my patients at the MVAMC. I called him the Piano Man because he liked to play the piano. About the time he walked onto the unit for one of his many admissions, we had just discharged a gal with anorexia. She had been on our unit for a couple of weeks, and none of the staff were sad to see her go.

After we got the Piano Man admitted, he sat down at the piano and started playing, and the piano sounded like a wounded moose. We opened the top to find the eating disorder girl had hid enough food inside of the piano to feed Hannibal’s entire army when he crossed the Alps to attack Rome. Including the elephants.

For someone who has never worked in a psychiatric setting, it would be easy to say that we, as staff members, totally sucked at our job, and I really don’t have much of anything to say in our defense. We were hardly specialists at treating eating disorders, and the fact we were so happy to see that particular patient leave speaks volumes to the level of struggle we all had with her.

* * * *

To be sure, it’s very easy to be an armchair quarterback or a wheelchair general, and criticize someone doing a job you’ve never attempted. And when you’re in a service oriented occupation like Nursing, you are never going to be able to make everybody happy. No one is that good, and people can be incredibly demanding/entitled. And it is generally the people who were making the least positive contribution to anything who were the most demanding and entitled.

You guys have to be the worst fucking nurses I’ve ever seen! I couldn’t tell you how many times I’ve heard that one. And it was usually a guy that you and your team had spent a month busting your asses trying to arrange housing and follow up for, who had been discharged from your unit forty-eight hours earlier, and was already back because he chose to drink as much alcohol and smoke as much meth as he possibly could before he came crawling back to the hospital.

Most of the time it’s better to just agree with someone like that, and walk away. But there were times when I couldn’t.

“Maybe you should get out more…  That means a lots coming from you…”

I said something like unto that to one of my unhappy frequent flyer guys at the MVAMC who probably spent as much time in the hospital as I did. His name was Ray. I’m going to guess that the total bill for the many, many times we detoxed him off of alcohol, sobered him up and set him up to succeed was in excess of one million dollars, and he had this response, “You used to be a good guy, but you need a new job. You’ve been inpatient too long.”

“So have you.” I replied.

He froze to death one cold December night in Minneapolis. He had gotten drunk and was walking to the hospital so he could be admitted again. His body was found propped up against a tree across the street from the hospital in the morning. He had stopped to rest before making his final stumbling trek to the ED, and had fallen asleep.

You meet a lots of guys like unto that when you’re a psych nurse. There was Charles. He was another MVAMC guy who spent an inordinate amount of time getting drunker than fifty guys combined, and the rest of his time detoxing on my unit.

We had safely detoxed Charles for the umpteenth time, and discharged him at 9:00 AM on a Friday morning. At 2:30 PM that same day, I answered the phone. It was Charles.

“Hey, I don’t think this discharge thing is going to work, man. I’ve been out of the hospital for about six hours, and I’m pretty fuckin’ wasted, man.” he slurred.

“Hey, Charles. Has it ever occurred to you that you need to quit drinking?” I decided to ask. There was a long silence, and then Charles said this,

“Is there anyone else there I can talk to?”

For one of the few times in my life, I had no response. I handed the phone to one of my co-workers. Charles would also die to death as a result of his alcohol abuse.

Sometimes the disease wins.

* * * *

You never know what you’ll see or hear as a psych nurse, and there’s a reason for that. People are capable of an infinite amount of kooky stuff, not that you have to be a psych nurse to experience the full spectrum of kookiness available out there.

All you really need to see that is a family.

But one thing you may not experience unless you’re a psych nurse is the dreaded Dissociative Identity Disorder, or more commonly, Multiple Personality Disorder. In my thirty year career, I met a lots of people who claimed to have multiple personalities, but none of them ever seemed to be legitimate to me, or anyone else I worked with.

Multiple Personality Disorder was virtually unheard of until the 1970’s. That’s when the book Sybil was published, 1973 to be exact. Three years later, the TV movie of the same name was broadcast on NBC, starring Sally Field and Joanne Woodward, and like magic, suddenly everyone had multiple personalities.

For my money, all of the people I met who claimed to have multiple personalities were just assholes looking for an easy excuse for their behavior.

* * * *

I was working nights at the MVAMC fairly early in my career. I was the Med nurse that night, so anyone needing any medications had to see me. Enter Sam. It was around 2:00 AM. We had detoxed Sam off of alcohol with a Valium protocol. Once someone had been safely detoxed, the protocol was discontinued.

Sam had been off the protocol for a day or two, but he wanted more Valium. I explained to him how the protocol worked, and Sam had a five star meltdown. He screamed at me, waking up everyone on the unit. One of the other nurses called the POD and got a one time order of Valium for Sam, and he went back to bed.

At 6:00 AM, Sam came up to the nursing station to get his morning meds. He was quite pleasant, and I remarked that he was much nicer than he had been at 2:00 AM.

“Oh, that. That wasn’t me. That was Samuel.”

“No kidding. He looks just like you.” I said.

Sam gave me, and anyone else willing to listen, a detailed description of his three personalities: Sam, Samuel and Sheryl. A line of patients had formed behind Sam. They were waiting to get their meds so they could go smoke. According to Sam, Samuel was the troublemaker. Sheryl was the lover, and Sam was the drunk. I listened to Sam, and gave him his meds.

“Well, the next time you talk to Samuel, give him a message.” I said. “If he ever talks to me like that again, I’m gonna punch you in the fuckin’ mouth.”

Sam’s jaw dropped. He turned to the guys standing behind him, “Did you hear that! He threatened me!”

“Hey! Take your goddamn meds and get the hell out of the way! And if you ever pull that shit again, if he doesn’t punch you in the fuckin’ mouth, I will.” one of the Nam vets growled.

Yeah, not one of my better moments, but Samuel never made another appearance.

* * * *

I think the last time I met anyone who claimed to have multiple personalities was at Aurora. I walked onto the Canyon Unit, and Nikki was on a 1:1. She was a frequent flyer, and I was usually her nurse.

A 1:1 is a special precaution, usually reserved for patients that are acutely suicidal. In essence, one staff person is assigned to one patient, and that patient is never more than an arm’s length away from the person assigned to watch over them.

Well, that’s how it’s supposed to work, but it’s rarely played out that way.

I went over to talk to Nikki. She had scratched her wrist with a plastic spoon on the evening shift. She didn’t even break the integrity of her skin, and her nurse had placed her on the 1:1.

I’m shaking my head while I write this. I don’t usually like to criticize the actions of other nurses, but that was a lazy-ass intervention. If the evening nurse had taken even five minutes to talk to Nikki, that ridiculous waste of manpower and resources wouldn’t have been needed. We barely had enough staff to cover the units, let alone have one staff assigned to watch someone for no good reason.

I asked Nikki to tell me what happened.

“I didn’t do anything! It was Alexandra!”

“And whom might that be?”

“She’s one of my three personalities! She–”

“Stop. Cut the crap, Nikki. You’re on a 1:1. You can’t smoke if you’re on a 1:1.” I said.

“But they let me smoke last night, and this morning!”

“I don’t care what they did last night. This is my unit, my rules. If I can’t trust you to be safe on the unit, I’m sure as hell not going to trust you to be safe off the unit, with a lit cigarette in your hand. What if you decide to burn yourself?”

“It wasn’t me! It was Alexandra!”

“I don’t care who did it. None of you get to smoke.”

“I’ll be safe, I promise! Please!!”

Less than five minutes. Mischief managed. And I never heard another word about Alexandra again. Ever.

* * * *

There was a fairly consistent response whenever I told someone that I had just met that I was a psychiatric nurse. Their eyes would widen, and they would say something like unto, “I bet you’ve seen it all, huh.”

I would reply, “No. I’ve seen a lots of strange stuff, but the kookiness of humans is infinite.”

And that is the fucking truth.

Every time I thought I had seen it all, something I didn’t think was humanly possible walked through the door. I eventually made peace with the fact that I would never see it all, and I was okay with that. My two other personalities are still sulking about that a bit, but they’ll get over it.

Or I’ll punch them in the mouth.

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