Rodeo Nursing

(Image from CafePress)

Thursday, January 29, 2009

I have a shirt that features a stick figure lying on a crudely drawn stick bed, arms and legs tied to the four corners of the bed.  The figure has a large circle for a mouth.  Tubes and machinery stand nearby.  Also nearby is a stick nurse figure, lariat looped in the air.  Beneath the scene, the comment, 'Rodeo Nursing'.

I am as respectful of my patients any nurse could be, but this kind of humor is a mainstay in our attempt o stay sane and deal with the worst aspects of our job.  I bought the shirt after many sessions of wrestling with an out of control patient, just another day at the office for us.

The reasons a patient becomes impulsive (I prefer this work to the commonly used 'combative') are many; medication reaction, an extended emergence from the excitation stage of anesthesia, claustrophobia, fear, disease related manifestations (such as brain tumor or trauma, epilepsy, or electrolyte imbalance, to name a few).  The reason is real, and a real concern.

All hands are on deck to protect the patient as we struggle to keep him or her on the bed, the tubes and monitors in place, and simultaneously solve the problem.  It is only afterward that we can take a deep breath consider the outrageous positions and feats we have accomplished, and laugh (so as not to cry).  Sometimes I go home with the adrenaline still coursing through my veins, jittery an tense,  My body does not know that the event was not a personal fight-or-flight moment.  It just responds as it is genetically and historically driven to do.

Laughing and being silly with those whose eyes one has looked into across the patient's flailing body is the best way to reenter and reorient.  To get rid of the jitters.  It is not intended as disrespectful to the patient.  I have never heard anyone make a negative comment directly pertaining to the patient.  It is more the event, the efforts, the positions, the play-by-play commentary that send us into gales of laughter.  'We are a team, and we beat the circumstances'.  Win/win.  The patient is safe and we helped keep them that way.  Go, fight, win.

The shirt is a reminder of the absurd and serious complexity of a nurse's life.  It cracks me up and makes me proud.