It is, really, all about blood.

There was blood on my front door. There was blood on the pedestal of the toilet, from a cut on her leg. There was blood in the sink--less blood than you might expect, but enough to stain it. There was blood on a door frame, where she'd richocheted off in coming through to the bathroom, where I put cold cloths on her ruined face.

An old friend of mine went looking for a beating and got it. Or maybe not; maybe she was looking only for resolution of the awful telephone calls her ex-lover had been making, and she didn't think he'd actually get violent again.

He did, and she showed up on my doorstep late at night, her face a mass of bruises and blood and snot, all mixing with her tears and her inability to speak.

I had never seen the damage one person could do to another, not up close without warning or intermediary. I've always seen it a couple of days after the fact, or in the clean environment of a clinic or shelter. It's never invaded my house and my peace before, not like this.

There were phone calls after that, and a conversation with a very nice cop with a twisted sense of humor, then trips to the police station and the emergency room. I found myself at home at two o'clock in the morning, making unanswered phone calls in an attempt to decompress. Eventually, unable to sleep, I called Nurse Ames, who I knew was working, and met her for breakfast a few hours later. Nurse Ames is sweet, soft-voiced, unflappable, and the toughest bitch kitty I know.

I got home to an email message from Land's End. Apparently, Sane Me had taken over and ordered Freaked-Out Me an entirely new set of bathroom towels. I needed them anyhow; the old ones are ragged and literally coming to pieces, even if they hadn't been spotted with blood.

There wasn't a lot of blood, but it wasn't blood I was prepared for or shielded from. It was blood that was born of a series of really, truly, amazingly bad decisions on the part of somebody I'd hoped would be smarter. It was blood that I didn't want to have to deal with, that should never have dripped on my floor, gotten smeared on my wall. There were myriad better ways to handle this that would've never meant bloodshed, and all those myriad ways got ignored. That left me to deal with the aftermath and the consequences and the public records and the police statements.

I am angry, and I am sick. I'm sick because the person who did the damage was methodical, almost scientific in his application of fists. I'm angry because the person to whom it was done knew better. She crawled back to the tiger cage after the tiger had taken off her leg. Nobody, ever, anywhere, deserves a beating--but you have a responsibility to your own self not to place yourself willingly into that situation when the alternative is easier.

There was no need for this. From start to finish, there was absolutely no need. I've had trouble sleeping since that night, and I've had trouble finishing both meals and sentences. I don't know what happened to my old friend; my first reaction--and I think it's a good one--was to offer help, and when that help was refused, I cut off contact. I don't need that brand of crazy coming around. Willfully putting oneself in harm's way without a larger purpose is not something I can support. Especially not when everyone around you has been campaigning against it for a year or more.

Things tonight are quiet. The dew has already risen; it's humid out, and we'll have storms in a few days, but for now everything smells fresh and new and, most of all, clean. The salvia is getting ready to explode in that way that it does, out in the front beds. Tomorrow I'll buy tomato plants and lavender and basil, scrub the remaining blood off of the grout in the bathroom, and change the sheets. In the afternoon I'll mow and plant and then lift weights.

I used to be annoyed by the amount of hair that my boys shed. Between Max and Notamus and Flashes, there's a lot of hair balling up and rolling around my floors. Now, though, I'm grateful that I can turn on the vacuum and have it be out of sight, out of mind, and gone.

Warning: extremely offensive, disturbing story. And for once, I'm not kidding. (Language and situational caution, too)

I work with a triad of jerks. All are members of that traditionally oppressed and demoralized class, the middle-class white male. All vote so far to the right of the Republican party that they're practically standing on *my* left (which is saying something), and none of them have any problems being bigots in public.

After hearing talk about "Indians smell funny, drive badly, and are taking all our jobs" and "Mexicans don't come here to work, those welfare-cheating bastards" and having to deal with some misogynistic crap that was directed at me specifically, I thought things had calmed down.

(Incidentally, my Beloved Sister's Husband, who is from India, responded to the "taking all our jobs" comment with "Yep! And we're taking all your women, too!" Which is why we love him.)

It's been a quiet week at Sunnydale. Nobody was showing me pictures of redheaded models in positions that suggested that they'd been brutalized and pointing out that the model, like me, is a redhead. Nobody was talking particularly offensive stuff about whether the White House was still, you know, white, har de har de har. Nobody told one single rape joke. I relaxed.

Bad idea.

Today one of the members of the Oppressed Minority showed me some of the funny, funny pictures on his iPhone. Most of 'em were of the Failblog variety--cars halfway off of docks ("Women drivers, har de har de har!") and cows in trees.

The last one he showed me was of a noose hanging in front of a hand-lettered sign that read "NIGGER SWING SET." (Yes, I used That Word. On purpose. Because the whole episode still feels like a kick in the gut.)

I'll give you a moment to get your jaw up off the floor.

Of all the offensive, brutally racist, entirely-inappropriate-for-any-situation things I've ever seen, this was right up there in the top, oh, one. I'm sure I've seen something worse, or heard something worse, but I can't call it to mind right at the moment*.

It shocked me so much that the anticipatory polite smile I was wearing for the next visual "joke" froze on my face for a moment before my jaw dropped (that's a weird feeling, by the way) and I said, rapidly, "Oh, no. No, no. That's not funny at all. What the hell. NO."

Because, really: What The Fuck Is Wrong With You, That This Is Funny?

I live in Texas. Our last lynching was in 1930, in a city called Sherman, up near the Oklahoma border. Well, our last "official" lynching--there have been plenty of people murdered in the years since by being, for instance, dragged behind trucks (remember that one?).

Our last lynching was well within the memory of a lot of the people that I work with on a daily basis. It was five years before my father was born. That puts it well inside my personal limit for "immediate experience". Yet you think that a picture of a noose combined with a racial slur and a reference to the murder of 551 black men (that's Texas' count) is funny.

This brings up two problems for me, one micro, one macro:

As I told my friend The Hurricane not too long ago, I'm not interested in changing these guys' hearts and minds--that's beyond me. All I want to do is to get them to shut the fuck up with their racist, misogynistic bullshit at work. There's only so much fighting one person can do against a cadre of ignorant people, and frankly, I'll call it out when I see it, but don't expect miracles.

If one of them does something jackholed, I can fight that one thing. I can resist, on a teeny-tiny scale, the sort of crap that they spew. After all, eventually this assignment will end and I'll be on the opposite side of the clock from them. Until then, it's worth a little discomfort to get them not to be threatening and horrible at work.

But the macro side of that problem is what disturbs me. These are three guys who are incredibly, incredibly privileged by virtue of being white, male, and middle-class.

They don't see that privilege, but again, unexamined privilege (though it drives me nuts) is a larger problem than I can solve in my one-woman consciousness-raising efforts.

What bugs me is the ignorance.

I'm sure they wouldn't hesitate to help a person trapped in a burning car, regardless of that person's race. I've never seen any of them refuse an assignment based on the race, sex, or sexual orientation of a patient. They treat the black, Indian, and Hispanic folks we work with with as much respect as they treat me (yeah, I know). Yet they have this worldview that, I don't know, the only good Person-O'-Color is the POC I work with, or something. The rest of those brown people are no-good, thieving, border-busting scumbags, present company excepted.

And it makes me wonder what they *really* think. If you're enough of a bigot to think a lynching joke is hi-larious, how do you *really* see all these people you're working with?

Again, as long as they don't shove it in my face, or think that they can intimidate me by making thumbfingered references to violence against women, minorities, and liberals, I'm cool with calling out the bullshit one incident at a time.

In the bigger view, though, it makes me feel like standing with my back against a wall for the entirety of the shift, just because I don't know what these dudes are going to throw out next.

It also makes me want to cry out of frustration, because some people are just so stupid.

*** *** *** *** ***

*On second thought, I don't remember anything that's worse than that funny ho ho de har de har sign. I would continue to wrack my brain for something more awful, but honestly? I'm nauseated enough as it is.

As Pens the Lotion Slut says, "I AM DRINKING BEER."

It has not been a beautiful day in Nurse Jo's neighborhood. Not at all.

Because the person who directs my Clinical Experience is a little.... .... ....well, she's weird, I had got to go to a two-part ACLS class this week, rather than renewing in April at the six-hour test-and-megacode extravaganza that I'd normally do. That meant two days of long classes covering things that I really don't ever want to have to deal with, and then a megacode at the end of the day today.

Followed by another megacode.

Yes, my friends, we tested *twice*. Once on a nice, boring, nonanimated dummy, and once on an animated dummy that costs a gazillion bucks and has no bones to speak of (the dude running the lab got really exercised when I bent the dummy's leg backward and said "Look! Osteomalacia!") and could speak and blink and breathe and all that happy shit. This was because the group I was in got selected randomly for a study on who did better in a code--a group with a nonanimated dummy, or a group without.

My hands and shoulders are sore as hell, because there were two very capable women in the group who were both unfortunately the size of my little finger, one guy, and me. Guess who got to do most of the compressions on both code tests? If I tell you that my private nickname for the guy is "Mister Lazy ThinksHe'sAmusing," will you guess right?

And if I tell you that I was, at one point, stuck for more than an hour and a freaking half in a room with Mister Lazy ThinksHe'sAmusing and another classmate whose nickname is HandsyMan, will you pity me? Will you hand me another beer? Please say yes.

Oh, never mind. I just got one on my own.

For some reason, since I've been single again, I've been attracting the sort of men one usually only sees in sitcoms and bad Craigslist ads. If he's got a girlfriend, he's hit on me. If he's an instructor in a nursing program and has a Marine Corps symbol (although if he's been any closer to the Marines than I've been, I'll eat my socks) dangling in his chest hairs, right above where his potbelly begins, he's said something inappropriate to me. If he's married but handsy, I've had to duck out from under unwanted shoulder-rubs, Angela-Merkel-style, more than once in the last month. And the topper came, as I was telling the Brother in BFE the other week, a couple weeks ago at my favorite bar.

My favorite bar is a class establishment that attracts only the finest folks--dames like myself. I was minding my own business, tucking into a poblano-stuffed chicken breast or some of the shrimp enchiladas that Antonio makes, or maybe it was a burger, when a drink appeared next to me.

I looked across the bar. There were three possible drink-senders, none of whom looked real promising. So I asked the bartender, Ray, who'd sent it. "The guy with the bad hair" she replied.

"Which one?" I asked.

"The one who doesn't look like he's bathed for a week."

Yes, fiends and neighbors, the dude with the bad greasy black hair, the corduroy Sansabelt-wannabes with the patch pockets on the front, and the reindeer sweater had sent me a drink.

He'd asked Ray what I was drinking. She'd told him single-malt Scotch, so he'd sent me Maker's Mark.

Oh, dear.

Ooooohhhhh, deeeeaaaaar.

I smiled, toasted him silently from across the bar, and returned firmly to my book. A few seconds later, somebody cleared his throat right next to me. Damn. Sansabelt Reindeer Man. So I thanked him politely and looked interested politely as he proceeded to try to make conversation. After all, they know me there: if anything untoward were to happen, Ray and her barback would throw the guy out on his ear. And he was really sweet, if kind of inert in a geeky way, until--and here you have to take a deep breath--he comingled the Star Wars and Star Trek universes in a way that showed me he was ignorant of both.

The way I figure, if you're living in Mom's basement, you have time to study these things, to work them out. Don't try to impress the girl who knows Yoda's middle name (it's Heironymous). Don't try to snow me with yammering about how we could go where no man has gone before if I'd just take hold of your lightsaber. Okay, it wasn't quite *that* bad, but it was close.

I've learned a lot of things in nearly forty years. I learn a lot of things from each guy I date, and I learn a lot when I'm single, too. And I've learned a lot--a lot--from this internship.

What I didn't expect to learn at any time was how to avoid weirdos in bars and how to avoid ass-pats while doing compressions.

*sigh*

Newsflash: Some Nurses are Assholes!

Okay, okay. Some people are assholes. And some assholes are nurses. I expect assholishness in the general public, but I don't always expect it from nurses. When I encounter a nurse that is unprofessional, it always shocks me a bit.

I spent the day at Holy Kamole, orienting to their CCU, which is much different from Sunnydale's. For one thing, the folks at Our Lady of Perpetual Propofol see many more heart patients than we at The Brain Barn do (ie, we see exactly none). They also get fresh transplant patients, folks in end-stage whatever disease, people with flaming CMV infections everywhere but their brains....you get the idea. The patient population is varied, totally not brain-screwed, and very, very sick.

So: Imagine a freshly-scrubbed, almost-recovered-from-her-weekend Jo bopping on to the floor a bit early. (I always get where I'm going a little early, so I can orient.) The night charge was kind enough to take me around and show me the various cubbyholes, then show me where they hide the snacks, and get me into the computer system. Then the day charge showed up.

And promptly completely ignored me when I ventured to introduce myself. No, seriously. I walked up to the desk, made eye contact with him, said "Hello-my-name-is-Jo-I'm-from-Sunnydale-and-I'm-orienting-today" and watched in disbelief as he looked levelly at me, then turned his back and walked away with a heavy sigh.

Um. Okay.

Sorry to be using your oxygen.

The day improved after that, as my preceptor was one of those fantastic teachers who never gets tired of explaining *why*, exactly, you need to level this line here or give these medications in this order. I love whys and wherefores. She gave me oodles of them. She also sent me hither and yon to see things like pacemaker interrogations (for non-medical folks, that involves a computer, not tying the pacemaker to a chair and threatening it) and emergent intubations and the nastiest case of scabies I've have EVER seen (the dude's right chest was covered with crust and his nipple was totally gone). So, all in all, a good experience--if you ignore the charge nurse, which I did.

Until emergent intubation number two, for which I was the runner. The charge turned to me and said, "Get saline."

"What, exactly?" I asked. "Bag? Flush? Bullet?" (Any one of the three would've been logical.)

He sighed deeply again (good thing he's well-perfused) and said, as though I were Forrest Gump on a bad day, "I need a bag of saline. You know, the big one. The liter one. With tubing. The kind with the spike on the end. You think you can do that?"

I did not shove the bag of saline (the big one, with tubing) into his ass. Instead, I brought it back in record time, considering that the bags of fluid and the spikes are kept in totally different places across the unit from one another, and handed it to him without comment.

Then we went back to ignoring one another for another few hours.

When the night nurse who was taking my patients arrived, she looked me up and down and said, "Oh. You're a new nurse. From Sunnydale." You could've cooled beer with her voice. Again, resisting the urge to put her into one of her own beds, I gave her the most thorough report-by-system I've ever managed to pull out of my hat, without comment. (And thank Frogs I had managed to do everything including fluff-and-puff for my patient, thus leaving nothing about which she could complain.) New nurse, yes. Stupid nurse, no.

Asshole? God, I hope not.

This may be the first time I've ever written a song in honor of a patient.

To the tune of "Mister Sandman":

Mister Dickwad,

Please get well soon;

Can't wait to see a diff'rent face in your room.

You drove me crazy for thirty-six hours,

You pushed the limits of my nursing powers!

Dickwad, I'm at the end

Of any rope I had: I am not your friend.

Please, please get out of your behh-heeed,

Mister Dickwad, heal up your head!

(Backup singers: fuck fuck fuck fuck fuck fuck fuck fuck fuck fuck fuck fuck)

Mister Dickwad, please don't you say,

That sterile fields make no difference each way;

Please don't imply that my training ain't real

Get meningitis: we'll see how you feel!

Dickwad, I've had enough

Of condescension and of your acting tough,

Please, please get out of your bed:

Mister Dickwad, heal up your head!

(Backup singers: dumb dumb dumb dumb dumb dumb dumb dumb...)

Mister Dickwad, can't you shut up?

I need some Scotch, yes, at least half a cup.

I'm tired of your ass-grabbing behavior

Your weakened state here will not be your savior!

Dickwad, when the cops find

Your charred remains, I will be on their mind.

But you know I'll be acquitted:

Mister Dickwad, you are half-witted!

Sadly, this particular patient was alert, oriented in all spheres, and totally intact. Also sadly, he was just a bit too big for me to strangle efficiently.

Sometimes I just want to go back to waiting tables.

What I Did Today

Fair warning: If you are at all faint of heart or queasy of stomach, do NOT continue to scroll down for the majority of this post. Beloved Sister, this means YOU.

Today I decided to take the sink out of the utility room. It's a bathroom sink of the molded-fiberglass type, and it--along with the cabinet on which it sat--turned out to be the only overbuilt things in this house. Everything else that I've needed to tear out has come along nicely, but this nearly stumped me.

This is the sink in question. You can see from the steel wool on the floor that I had had some trouble last winter with mice in the house; they were coming from under that sink. Also visible in the foreground is my Weapon Of Destruction. I had to take the whole damn thing out in one piece, sink, cabinet, and all, as the previous owners of the house apparently installed the sink using construction adhesive and the Power Of Isis.

And here's what I found when I removed that sink and cabinet:

Yes, friends and neighbors, that is torn-up insulation. And old church tracts. And some weird plastic things, and part of an electric toothbrush, and TONS OF OLD RAT SHIT.

This is by far the most nightmarish thing I've found in redoing the house so far.

Now I have a nice box built to cover the old plumbing, like so:

Much nicer. The whole thing's held in place with three screws, so I can take it down without any hassle when I'm ready to replumb.

Tomorrow is painting and shelf-building and weight-bench-repairing day.

Sheesh.

Just sayin:

The way to make nurses orienting to your floor is not, perhaps, to look at them and say "I don't want you people touching any of these patients! Not even to take vitals!"

Well, okay, then. *shrug*

He doesn't like you. I don't like you either.

Max went batshit insane today, just as there was a nice big storm blowing in. Normally, Max does not go batshit insane with storms; he instead scratches apologetically at the door and asks to be let in.

Not today, though. Today was growling, snarling, barking, howling insanity in the back yard.

Now, I have to set this up for you:

Imagine the biggest German Shepherd you've ever seen.

Cross that with something that's mostly blonde, much stockier than a G.Shep, and equally as furry.

Add a healthy dose of Mellow.

Toss in some love for kitty-cats.

Slap on a couple of pounds of happy, add a schmear of totally unflappable, and take out all the ditzy, weird, spooky behavior that overbred dogs can have.

You'll end up with a mutt who, like Max, is normally the calmest, most Zen being on the planet. He barks, yes, but it's understood that he's not really barking at the postman; it's a formality on both their parts. The postman regularly comes over to the fence to scratch Max's ears. Likewise, he'll bark at dogs wandering past (and bay at his girlfriend the basset hound), but he would never growl at or bite your average dog that comes right up in his grill. He's mellow, you see. He's kind of a Southern-California type dog, taking each day as it comes and chilling out.

So, when he went absofrigginglutely batshit insane, I let him in. I figured there was something out there that I needed to be aware of, and better he's in the house than out of it.

Sure enough, the doorbell rang.

Max went straight to the door, ignoring my "back" and "sit-stay". He stood at the door, looking interested. This is normal. Ignoring "back" and "sit-stay" is not. I opened the door.

On the doorstep stood a clean-cut young man who was obviously there to sell me an alarm system, or offer one for free for a limited time only! or beg me to put his company's sign up in my front window.

Max stalked forward, ears up, hackles rising, legs stiff, normally-curly tail straight out behind him. There was a low, almost-sub-audible growl that I could feel but not quite hear coming out of his chest. The guy on the porch said nervously, "Uh...nevermindseeyoulatersorrytodisturbyou" and left as quickly as I've ever seen a person leave who was not actively being pursued by an unholy combination of fire ants, cicaida killers, and door-to-door evangelicals.

Max got some cheese. ("Cheese? I LOVE cheese! How 'bout some bay-cun too?") He's now lying calmly under a tree in the back yard, grooming his hind feet. All the doors and windows are locked.

Let it never be said that I don't know how to take a hint.

Monday Morning Remedy: Spice-y Edition

Testing... ... ...testing... ... ...

Today I kicked ass and took names. We had tests. I love tests. I especially love tests that have to do with little scenarios you read and analyze, then try to figure out what to do first, when to call the doc, and when to tell the patient to calm the heck down, everything's really and truly fine.

Of course, these were critical care scenarios. I am a med-surg nurse by training, so there was a certain amount of thinking that had to go into things. And, as a Minion heard recently, you can't always put down real-life solutions to test questions, because what the accepted nursing practice says is different.

For instance, take this scenario: a patient has a heart rhythm that's consistent with having too much potassium in their blood. What would I do in the real world? Why, I would draw a stat serum potassium. Then I'd call the resident. While waiting for the lab results, I would get a stat 12-lead EKG in order to get a clearer read on what was actually going on. I would check IV access and stop any potassium-containing fluids that were running, then call the pharmacy and give 'em the heads-up that I'd be needing Kayexalate soon. (Kayexalate is an oral suspension or enema that pulls potassium into the large bowel where it can be excreted.) By that time, the resident would've called me back and I could present her with all the necessary information.

Sounds pretty good, huh? I thought so. Unfortunately, I was totally, utterly, completely, unequivocably wrong. The first thing I should've done was page the resident. Paging the resident comes first in the book world, because in the book world, nurses aren't given as much autonomy as I've had for the last mmumphm years. In the book world, nurses do not act autonomously. They wait for residents--even if the resident is horribly underslept or doesn't know much about the patient--to make the call. The most we as nurses can do is make gentle suggestions as to courses of action.

If you've read this blog for more than five minutes, you know that is not the way Jo rolls. If I can save a resident from multiple phone calls, regardless of the hour, I will do so. Part of my job is making *their* jobs easier.

Anyway, I mostly kicked ass on the four-and-a-half hours of testing. The one thing I really quibbled about was when I was docked points for checking the output of a patient who'd recently had a neobladder created and who was complaining of intractable pain. The book answer was to treat the pain first (Pain Takes Precedent, another lesson I forgot) and then worry about output. My feeling is that if you've got a brand-new neobladder (that's a bladder that's made from a section of small intestine), you ought to be worried about output first, because the damn things can tear open if the catheter in them is occluded by mucus (a common neobladder problem), and then you've got a bellyful of hot piss, and then where are you?

But no. Tylenol first (TYLENOL? WHAT PLANET ARE YOU PEOPLE FROM??), then check output, then page the doc.

*sigh*

So I came home and opened all the windows. Now I have a pot of black bean chili on the stove and a happy Max-dog nuzzling my rib cage. Later I will eat large amounts of veggie black bean chili and take the rest to Pastor Paul next door, then fall into bed. Tomorrow, after all, I'll be back on the floor bright and early.