Understand this,

If you’re working with me and you utter the word ‘quiet’ in any context, I’ll kill you like you’ve never been killed before. 


So I paid for the Pearson Vue Quick Results this morning because I couldn’t take it anymore.   








 I PASSED!!!!!!!!!!!!!! 

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 I am now officially Arielle R., BSN, RN.


My Baker Act patient called me into her room requesting Tylenol. I asked where her pain was, she shared that she just had her nipples pierced and they are hurting her badly.

I went to the ER doc and reported this complaint. He laughed and said “No”

I said, oh, I mean she has a headache, can she have tylenol? …he said “YES”


This Weeks Episode is Called: “You should not be in the ED”

“My child has a temperature of 38c” - Didn’t even attempt to give paracetamol and it was a weekday.

“My child has sticky eyes” - Ok, I have a slightly sticky nose, next?

“They’ve had a cold for over 2 weeks!” - Yes, which of these two things is this situation, either, an accident or an emergency?

“I’ve hurt my thumb” “Ok, where exactly?” “Oh, the thumby bit” - Actual quote. Then sitting in the waiting room texting 1.3 seconds later. 

“They vomited”  - … they vomited once. After a feed. Babies do that you know? 

“They won’t stop crying”
“They’re not crying now….”
“Oh, thats because I fed him” 
Sweet mother of….


Secrets of Great Doctors

[ As seen everyday through the eyes of Nurses]

1. A doctor who, above all, respects the inherent worth and dignity of every patient regardless of socioeconomic status, disease, race, ethnicity, or personal judgments as imparted by another health care professional.

2. The doctors who do not dismiss the concerns, or instinct of a nurse, nursing student, or med student.

3. A doctor who isn’t afraid to admit when he/she is wrong; to the patient, the nurse or any student in their charge - and a beautiful sincerity in apology without blaming others for what they are responsible and accountable for.

4. A physician who respects students of all descriptions - med students, nursing students, PA students - perhaps likely remembering the beginning of their own journey. One that respects the inherent worth of all his/her colleagues from the housekeeper to the cafeteria worker.

5. A doctor who actually does their assessments, not just standing by the door, observing and charting inaccuracies. Moreover, there is something memorable about the ones who not only anticipate quality of care, but the ones who take the time to listen intently to, and care for their patients.

6. A doctor who doesn’t embarrass, or make examples of a nurse, resident, or med student during rounds when they answer a question incorrectly - and actually takes the time to explain so there’s learning involved. (Not to mention respect of their knowledge and patience).

7. Physicians who understand that there’s sometimes a time to let go, despite any heroic measures, there’s insight of what would be best for the patient, over relentless interventions.

8. A doctor who doesn’t come out of a patient’s room to ask a nurse/nursing assistant to put a nasal cannula on, fetch a glass of water, blanket or any basic items that a patient is also probably secretly wondering why they have to go get someone else to help me with something so simple; and while some of the more time consuming tasks are not expected - it’s always so very appreciated when one takes the time to assist a patient with positioning, or cleaning.

9. Doctors who stand up for nurses to the Nursing Supervisors, or one who defends the nurses when a patient or family member is being disrespectful.

10. A doctor who on any given day, amid the overwhelming stress, chaos or fear will always find a little humor, and never lose sight of why they chose to honor their oath of care.

In light of the most recent fucking horrible abuse of power by a cop, I have done some research.

I’ve been musing on the nature of public service jobs since the video of the Texas pool party surfaced. Because I know the immediate response is “Oh, cops have a dangerous job! They need to protect themselves!” 

Here’s the thing. In 2011 in the US, almost fifteen thousand police officers were injured in an assault on the job. Factoring in the number of police officers in all US agencies that year (a little over 1 million), that is an assault injury rate of… 1.4%? 1.5% if we are being generous?

US nurses have an estimated yearly rate of injury by assault of roughly 1.7 million. The best we have is an estimate of this number because, as someone working in the field, we report a fraction of the assaults that actually happen. It is the one fucking job where you shrug off someone trying to fucking bite you as “oh well, it’s Tuesday.” Factoring in the number of US nurses in 2011 (nearly 4 million) that is a rate of 43%. Nearly fucking half of us. 

We are not trained to take down men built like tree trunks, fucked up on whatever shit they could get their hands on. We are trained to de-escalate people which does exactly jack shit when faced with someone suffering a psychotic break because of the drugs she is on. But we wade in there, often endangering ourselves in the process because it is our fucking job to take care of them. Regardless of what they are trying to do to me or are calling me in the process. 

So, no. I don’t buy it. There is no excuse for manhandling and shooting unarmed children. If a child makes you fear for your safety, you have picked the wrong field my friend. But do not act like the nature of your job necessitates violence. 

The Five Stages of Studying

1. Denial: You refuse to acknowledge your lack of knowledge for the coming exam. You know everything, it’s going to be okay. Books are put at the wayside and other more pressing matters are attended to- like watching every episode of Downton Abbey back-to-back.

2.  Anger: You realize that you have an exam coming up and that you know less than you though you did. You are upset that you didn’t start studying sooner. You may become infuriated that the exam is even a requirement. I mean who needs exams??? This stage may be accompanied by attempting to sit down to review, but is shortly followed by frustration in which you throw the books across the room. 

3. Bargaining: You try and tell yourself that you can study, that it will be okay. You alternate between watching only ONE episode of your favorite t.v. show for every one hour spent studying. Food may be used as a reward for completing actual work. 

4. Depression: At this point you realize the insane amount of work that you have before you. The task seems enormous and you just can’t do it. You may begin crying mid paragraph. 

5. Acceptance: You have determined that studying is the only way to pass the upcoming exam and that happiness is only one exam away. You read and take notes like you’ve never done before, practice questions are done with zest. Generally this stage occurs within 24 hours of the exam.  

I’m still working my way through stage 4…. 

Common Misconceptions About Nurses

1. We flunked out of Med School.That would be a no.. A hell no. First, and foremost, we CHOOSE to be nurses. The caregiver on the frontline, entrusted with patient’s safety, direct patient care, vigilant monitoring. There’s a reason why attending doctors request that nurses come on rounds; we are the primary source of information about the patient, and as a sidebar; we have education and training that reaches Masters and Doctorate levels, but we are more interested in being called “nurse.”

2. “You clean patients and give bed pans….isn’t that demeaning of your job?” One hundred percent of our job includes doing whatever it takes to help a patient feel more comfortable. Yes, at times we find ourselves wiping bottoms with explosive diarrhea, excrement we didn’t know a human body could hold, we wouldn’t be human if we didn’t admit it didn’t affect us personally - Yet this is how we see it; Preserving a patient’s dignity is never demeaning.

3. “But you only have a patient or two. It doesn’t look that hard on TV.” Follow a nurse around for even an hour, and you may rethink this statement. In critical care, Peri-Op, or home care, you may have one or two patients, but you will work hard every damn minute of those twelve hours. In Med Surg, ER, L&D, you may have up to 10 patients or more, many at critical status, but they are extremely busy patients, many of whom are de-compensating, and here you will barely have a minute to catch your breath. TV only touches the surface of what we do, and is glorified for ratings. TV doesn’t show the labors of slaughtering a body during cardiac arrest, the sweat of our bodies in a crowded room, the honesty of fear, the shouts of doctors, nurses, house supervisors, the agony of losing a patient - and the reality of cardinal errors. TV doesn’t accurately portray how a nurse feels after a gut wrenching day of attempting to save a life, the insomnia, the late night thoughts of “what if”.

4. All nurses want to marry Doctors, and all Doctors flirt with the nurses. While it’s true that many romances are sparked from proximity, commonalities - and perhaps some innocent flirtation, it doesn’t imply this is the only connections we will find at work. There’s also other nurses, techs, nutritionists, pharmacists, respiratory therapists - nurses may flirt with doctors, but they also may have a mind blowing conversation with the transporter who everyone else underestimated to be less than intelligent. Nurses are interested in the human beyond the title, and beyond the mask.

5. Doctors do not respect nurses. Not always accurate. Respect, and lack thereof, is attributed to a person, and their character, not specifically the profession. While there may be doctors who talk down to nurses, there are also just as many doctors who treat nurses with the utmost respect, valuing their collaborative input, and as an important sidebar - nurse have the utmost respect for what a doctor does for their patient. Every hospital role is unique, stressful, and has its own challenges and rewards. And nurses respect that.

6. “You get more days off than regular jobs. You should be more energized”. That would be a no, as well. Every job, not just nursing, has its own stresses. It’s incorrect to assume that nursing is a light job merely based on less days of work. We work 12 hour shifts, often longer when a patient is in distress. We require a great deal of rest and often solitude to reflect on the enormity of what we recently faced, and our decisions. We often prefer the company of just our pets, who have no demands except to be near us. We may like to go to a party, but find ourselves exhausted after only a drink and overwhelmed by too many people, longing for sleep and the bliss of drifting off into oblivion of only calming thoughts - we actually admire anyone who can finish a day’s work and be fresh enough to go out that same night. Maybe people perceive us as boring homebodies, but we are sometimes just honestly content with perfect quiet, a sort of stillness so we can face another day.

7. “ The doctor saved my life.” In many regards, this is true. The role of the doctor is integral in patient care. However, it would be incorrect to assume a life is saved unilaterally. Nurses make critical decisions that contribute to saving lives. But it would also be incorrect to assume nurses are the only ones saving lives. It takes a team effort to save a life, and often it starts with the patient care technician, or the nursing assistant, who noticed something was amiss. It’s the collaboration of many disciplines that anticipate, and contribute to quality of care - from the lab tech who draws blood when no one else can find a vein, to the radiologist with educated diagnostic skills to the pharmacist who catches fatal errors. Everyone’s role is unique, everyone’s role is important. And everyone has one goal. To care for, and maintain the dignity of human life.

8. “There isn’t any real growth in nursing. You’ll always be a nurse.” This may surprise people, but we are just fine being called a nurse. But do not say “just a nurse.” It minimizes what we do. Nursing actually has a great deal of growth opportunities. Many of which the public do not even see. And we are ok with that. A great deal of growth is internal, and we carry that with each patient we meet. Besides, titles do not solely bring respect. It’s character, and how well we honor one another and what we do.

9. “Nurses complain all the time.” Hmm. This may be true. Oops. We spend 12 hours practicing patience, mediating between doctors, families, pharmacy, advocating for patients, other nurses and debating supervisors about safety. We are not complaining about our job. We love being nurses, we are complaining about the LIMITS of the job. Every job has its difficulties, its stresses, and struggles. This is just simply ours. Please understand, and support us when we feel discouraged, and not very social or cheery. Sometimes we are conserving our smiles and positivity for our patients and coworkers.

10. Nurses are strong, resilient and tougher than people would guess.
Actually, this is true ;)

My badge...

I remember the day I got my badge for work. The picture is fine- I don’t really care about a 1x1 square of my face- what I adored that day was the extra piece of plastic behind it. This piece hangs down lower and in white letters on a dark background, it has the letters “RN.” Back then, getting to call myself an RN was a new, fresh, joy, but lately that is different. Lately that extra piece of plastic, clipped along with my badge to the neck of my scrubs, has felt more like a burden than a prize.

Because of that RN badge, I cannot say what I want. I have to be nice to the utterly ignorant husband of bed 22. I have to be nice even when he says things like “I’m a mechanic and such and such works like this, so her EVM? - what’s it called?- Oh her EVD should work like this, and you nurses just don’t know what you’re doing- so I’m gonna sit up here and watch you- and even when you don’t see me and you think I’m gone- I might be right behind you.” I have to be nice when the wife of bed 4 insists I bring her two blankets and three pillowcases and “can you put gloves on before you touch those?” I have to be nice when bed 10 keeps on and keeps on and keeps on trying to yank out his own foley, despite the 800 times I’m reoriented him and explained the foley. It means I have to get up and check on my patient when she beckons me by TAP TAP TAPPING away on the side rail with her remote, despite my telling her that I am not a dog and she can speak to me like a person.

The RN on my badge also means I have to act. I have advocate for my patient,  when he needs pressors and the doctors see it, but don’t care enough to place the central line. It means I have to call and call and call the doctor when my patient’s pain won’t go away and he won’t change the orders. It means even when my back aches, it is still my job to lift and turn. It means that there’s no such thing as “not my problem,” when it comes to these patients.

Some days, I do not know if the RN on my badge is worth the weight it puts on me mentally, physically, emotionally, and spiritually. Being a nurse is one of the hardest jobs, and often there’s no “thank you,” at the end of the day. But some days, the RN on my badge  lets me be a part of the truly miraculous. When a patient goes from horrible subarachnoid hemorrhage to awake, alert and oriented. When a patient tells you you’ve given the first relief of their pain in days. When you become a part of their family and they become a part of your heart. When you hold your confused patients hand, and she has no idea who you are, but her eyes say she’s glad you’re there. When you can make your patient laugh and forget where they are just for minute. When you know you cared for that patient the way you would want your own mom to be cared for. When you love your patient and they love you and trust you with their life. The RN on my badge is one million things at once, it is wonderful, humbling, stressful, encouraging, oppressive, and empowering.

Sometimes I wish I didn’t have an important job. I wish I could be more relaxed about my work, that I didn’t have to constantly look over my shoulder to make sure I didn’t make a mistake. I wish my decisions didn’t matter so much. There are times that I love the responsibility– I think it makes me older than my 25 years. It’s given me great perspective on life and it suits who I am as a person.

But I get jealous of my non-nurse friends sometimes, because morbidity & mortality aren’t words in their vocabulary. I see their worlds as being a bit brighter than mine. In a purely emotional sense, their workload seems lighter and airier.

What’s it like to have some sort of blissful ambivalence to your job? Because even when I hate my job, I’m still passionate about being a nurse. I can’t be mediocre about it. I still care deeply, even when I’m frustrated. How freeing would it be, to honestly not care (TOO much) about what you do?