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F*CK YOU, Shonda Rhimes

2010 November 7
Posted by Nurse Me

The beeps, buzzes and blurps are growing louder and louder as I amble towards the trauma zone. With each step, the activity behind the trauma doors becomes clearer and clearer.

Shit, tonight is going to suck.

“Hey, Nurse Me! Pedestrian vs Auto coming to Rm A. Get in here now, day shift wants to go home.”

Well, waaah. What about when I want to go home and you want to cream and sugar your coffee first???

“ETA?”

“Landing now. It’s a peds (pediatric patient).”

Well, can I at least take my bag off my shoulder and put down my coffee? Guess not. Just like that I’m ushered by the elbow into Trauma A. One eager dayshifter taking the bag off my shoulder, the other taking my coffee. My ears are listening to some white noise (“suction ready? #s4.0 and 4.5 OETTs, blah blibbity blah, epi……..”) as my eyes are afixed to where the second dayshifter is putting my coffee. Aw, she does care, she’s even labeling it for me. Sweet.

It’s behind the label printer. Totally safe there.

The pediatric trauma arrives aromatically enhanced with helicopter fumes. The flight nurse is trying to give report but is wasting his breath. Other than “hit by car” we’ve all tuned out his report, focusing on the flaccid 5 year old in front of us. Phew, he opens his eyes and is moving all his limbs. Phew.

Uh oh. He has a concerning laceration to his forehead as well as a nice goose egg to the left side of his head. This is worrisome but right now he’s awake. He tells me his name is “Petey”.

The dad arrives as Petey, some doctors and I are rolling back from CAT Scan. He collapses to the floor, overwhelmed with emotion and fear. We look at him and make sure he’s breathing and conscious. We/I  really don’t have the time to tend to him right now. His little boy takes priority. Thankfully the Crisis Intervention Team is present and one of them tends to Dad.

I continue focusing on Petey, checking him over for bruises, lacerations, hematomas. It’s a challenge keeping him awake, which is concerning but so far other than the small laceration to his forehead and goose egg to the side of his head, Petey’s looking pretty good. Now please, just don’t vomit.

Mom arrives later, after all the scans, xrays and ultrasounds have been completed. Petey is knocked out but wakes up rather easily and responds appropriately for his age. Good signs.

I start to explain to Mom where we’re at in Petey’s diagnosis. I don’t get far before….

“I watch Grey’s Anatomy so I know what to expect. But where are all the doctors? Why aren’t they doing your job?”

I shit you not. This is verbatim what Mom said to me. I laughed hoping she was joking. She was surprised, taken aback.

I backpeddaled, “Yeah that show is pretty intense, I love the way the characters are written. But aside from how the cases are presented, there isn’t much medically accurate about that show.”

So, in honor of how hard nurses work and how awful Grey’s Anatomy is for nurses, here’s a little letter I wrote and read to a live studio audience.

Dear Ms. Rhimes,

As creator of Grey’s Anatomy, the most popular show on TV you clearly are doing something right, but as a nurse, a real ACTUAL nurse, not a TV nurse, I had high hopes that your show would portray more than doctors getting it on in the on call room and broken penises. But that’s not only how your show goes awry. First, there is no deep, dramatic last breath, that’s pretty difficult to do with a breathing tube in your mouth. Woops, none of Grey’s patients are ever intubated, my bad. No one has ever died in perfect make up as if it’s their last great head shot. There are no pauses for dramatic effect, plain ol’ dying takes care of the drama.

But I will give you this, Ms. Rhimes, you did get it right when you had that kid encased in cement. However, having attending surgeons bicker about their personal issues as they’re chiseling the patient out the hardened cement? No, that’s not where the real drama is.    

Real drama would be McSteamy bellyaching, “I’m a plastic surgeon not a construction worker, dammit!”  And refusing to endanger the integrity of what God intended his prized surgeon hands to do– shape and mold the breasts of soon-to-be hot chicks.

Seriously, Sho-Rhi, not to be a bitch, but resuscitating Patrick Dempsey’s career doesn’t make you a medical professional. So as a real nurse, let me pitch something to ya, Shon.

It’s 6:45 am. I’m already at the hospital. Before I even step off the elevator I hear wailing, lots of wailing. The door opens to reveal literally 100s of members of the Ortega family. Before I can put my stethoscope around my neck, an Ortega running loose in the unit grabs me, waves her hospital badge and demands to know where bed 15 is, because she’s (illegally) accessed the patient’s medical record and sees her “cousin” has been admitted to Bed 15. I say that Manuel isn’t in the unit, he’s in the OR. I just got to work, my Coffee Bean hasn’t kicked in, and things have gone from 0 to 100 in a nanosecond. But this is what I do. I watch this panicked and anxious woman as fear and anger change her face. She demands that the surgeon come speak to her immediately.  I tell her that isn’t going to happen because the surgeon’s hands are currently in her “cousin’s” chest cavity.

Then I’m yanked away by hysterical family members who are freaked out because the patient’s wife has stopped speaking and won’t open her eyes. The patient’s mother is sobbing, holding her hand over her chest saying, “mi corazon le duele.” She starts hyperventilating with the thought of her son’s death.  I try to get her to calm down before she passes out and that’s when the fist fight breaks out. Security’s outnumbered by ornery Ortegas, there’s shouting and tears and public prayer and I look around the room suddenly recognizing a condition that I’ve heard doctors and other health professionals use for years.  So pleased with my diagnosis, I said it….out loud, in what I thought was a muffled voice….in a room full of Mexicans…next to the patient’s sister.

“So, this is Hispanic Panic!”

What occurred next, well… that’s drama, ShoSho.  

Oh, one more thing, family members don’t know about A Camera and B Camera so they look at me in angst and anger, angry that a doctor hasn’t talked to them about the condition of their loved one. The gripe is legitimate, Shonda, and can’t be negated with a glass of nice, cold water.

Now I’m the enemy.

Perpetuating their pain.

Because I haven’t told them whether to sublet Sean’s apt or cancel the lease all together, what to do with Dwayne’s car or why Rico had only $270 in his pocket but he left the house with over 5k.  

And the doctor still isn’t at the bedside. But I am. Standing in front of them. And I do know what they want to know and how to say it. But Sho-Sho, sweetie, you don’t show any nurses on your show, so when I try to tell them, they won’t listen. 

Now ShoRhi, although you’re not scripting my words, I do know how to intelligently & compassionately talk to families.     

It’s what I do in between titrating drips, executing clinical decisions based on hemodynamic data, preventing VAP, Sepsis and ARDS, packing wounds and…. OMG! I gotta pee……, constantly paging the doctor with updates, requesting orders, answering the same question 32 x because the family can’t seem to talk to each other, assisting in emergency bedside surgery, and SHIT!…I worked through lunch again, hanging blood, drawing blood, trouble shooting the Vent, Ventric, and CRRT….

And when I talk to the Dr I say,

“his ICPs were 42-56 with the ventric open to drain @ 20. I gave Mannitol. His CPP fell to 46 I gave 25% x 2 because he’s already maxed out on Levo, Dopa, and Vasopressin. Now his ICPs are 27-32 but I think we’re headed towardsT4.”

But when I speak to the family I say,

“his brain pressures were too high so I gave him medicine to bring them down, it didn’t work as well as I had hoped. I’m not able to turn off the medicines keeping his blood pressure at an acceptable level, we’ve tried everything we know. There isn’t anything left to do.”

They look at me blankly…. “but he’s going to live, right?”

“No, I’m sorry, he’s not.”…..

……OMG! I still have to pee.

So thank you very much Shonda Rhimes, thank you for making nurses more invisible than we already feel and having to work harder to dispell the myths that you create.

Looking forward to working with you someday,

Nurse Me

PS – Petey sustained a mild concussion and was discharged from the pediatric unit 2 days later and in plenty of time to go trick or treating.

10 Responses
  1. JA-CNOR permalink
    November 8, 2010

    thank you, thank you, thank you x … Actually, I stopped watching Grey’s Anatomy after the 2 left the closet after sex, going immediately back to their dates without seminal fluid running down her leg!! and they never wear goggles when scrubbing for surgery, etc., etc. Where are these medical advisors? Have they ever worked in a hospital? My son died in a trauma center with a head injury exactly as you describe-we saw a physician once-the nurses were wonderful. I can only hope I was as compassionate to the families of my patients.

  2. November 8, 2010

    Yes, people’s perception is their reality – no matter how warped and biased it may be.
    Hollywood and the medical profession – *cough* *cough* sorry – the nursing profession don’t see eye to eye on anything.
    But then again – our glory is in our job itself-> not how we can tell a story about our job.

    Just wish we could find a balance so that our patients and families were better informed.
    Tough stuff.

  3. Nurse Me permalink
    November 8, 2010

    Sean,

    I think NOT telling our story is part of the problem, not that we have to do it in primetime but we do need to tell it. I once remember sitting in a conference listening to the speaker tell us that whenever there’s a national emergency, local disaster or public health concern, nurses aren’t the ones speaking to the media or offering to speak to the media. We aren’t proactive in promoting our profession and we’re quick to renounce praise or recognition (“no, there were a team of us involved in your loved one’s care”) One of her points was that it isn’t difficult to contact our local news station and offer to be interviewed as a health expert. And she’s right, we don’t.

  4. Nurse Me permalink
    November 8, 2010

    Oddly enough JA, one of the writers/producers of the show is a doctor that I worked with during her residency. I don’t remember having strong feelings about her one way or the other but if this show is any indication……

  5. November 8, 2010

    Like the post. I think you’re exactly right that we do it to ourselves — and what about all the colleagues who say, “I know it’s crap, but it’s a good show” and watch it anyway despite how it portrays nursing (or doesn’t.) Something nearly pathological about that. . .

  6. Nurse Me permalink
    November 8, 2010

    I guess we all like to be entertained?

  7. terri c permalink
    November 12, 2010

    I agree that nurses really could benefit from more visibility. Also, has anyone noticed that when some families want to see “the doctor,” they mean “the male doctor?”

  8. November 16, 2010

    Love it. Yeah, there’s suspending your disbelief…and then there’s Shonda Rhimes.

  9. November 24, 2010

    That is the best post I have read in a while. (Although i took a few years off while I was in the Stan again). I really should be doing my homework but I just needed a laugh today. Thank you.
    ~mika

  10. December 8, 2010

    loved it well put…i can imagine your day…and i was wore out after readin it

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