Saturday, September 25, 2010


Henri Cartier-Bresson, La Villette, Paris 1929

New-nurse-in-the-hood describes herself this way:

Baby nurse in the ED surrounded by nursing homes in the worst part of a big city. Consequentially, I get sworn at A LOT, and I'm growing up fast.

I've been meaning to recommend her, but as you know, I'm not blogging much of late. It was on my list.

Then the girl went and wrote this, impinging on my doggone hiatus. She calls it Compassion Deficit:

I think everyone has their type of patient that they just can't get over the feeling of wanting to kick. I've been a little surprised at myself lately at who it's been. I've always known that I can't deal with the entitled patients. I know why, and I've learned how to deal with them. But lately another sort of pet peeve- I hate to even call it that, because it's a little stronger than that- has crept over me for our addicts.

This may seem like a given to a lot of nurses, especially those that work in ER. But it sort of bothers me. I've always sort of felt deep inside that the reason I always end up with so many high drama psych patients is that God knows I know how to deal with them. I always thought that I would feel sort of a kinship or at least a deep empathy for addicts because of my own past. I was never a substance abuser, but I've dealt my whole life with a lot of unhealthy tendencies. When I was about 13 or 14, I started cutting myself. A couple years later, I also started dieting to a ridiculous degree even though I was already underweight. When I slipped up, I would make myself throw up. I didn't tell anyone. For a long time. When my family found out, and I realized how much it hurt them to see me this way, I worked very hard to stop. I had my setbacks, and I still have the tendency to do these things. I always will. The thoughts still run through my head, but I have it in me to stop myself because I think about how it hurts the people around me.

I think this is where I struggle. I hurt for our depressed patients. I hurt for the type of people who rely on some self destructive behavior to escape all the bad things they feel. But I hurt even more for their families.

I took care of a lady with liver failure and esophageal varices the other day. I remembered her face. I knew why she was here. Drank herself sick again. This time, though, her son was with her. I knew I would have remembered him. He was a big cherubic looking kid. Really quiet. Really young, about 21. He never asked us for a thing. He sat there and stroked his mom's hair and held her hand while we tried to start an IV on her scarred-up shit veins. I don't think she even really acknowledged his presence. She did demand Dilaudid from us while he sat outside the room and cried. He asked one of the nurses how much it would cost to get his mother a liver transplant. That was enough to make me cry, too.

And my patient last night. Came in via EMS for approximately the 50th time this year. Took 9 Vicodin at once for whatever bullshit pain complaint she made up at that particular moment. Her tooth...nope. Maybe her back. And/or neuropathy. Wherever the pain was, she wasn't trying to kill herself or get high. She was just trying to make the pain better. In fact, the pain was still there, could she get some more pain medicine? Yeah. No. So her husband came back. Apparently this was a pretty regular little routine for them. By the way, she'd also been popping Xanax all day like they were sweet tarts. She does this and passes out, he says, so he just calls the ambulance as soon as she does it. Take her meds away, we tell him. Nope. Can't do it. Supposedly if he takes her meds she throws boiling water on him. Why he stayed with her I have no clue. But he did. The whole night he hugged and kissed her while she drooled. He cleaned and changed her when she peed on herself. This is my wife, he said. I married her because I love her. The EMTs who ran on her knew her by name. They said he would run down the block and use the pay phone to call 911 because she got so irate and abusive when he did it, so he would call from outside the house and pretend it wasn't him. I felt so awful for him. He clearly loved his wife so much, and there was absolutely nothing he could do for her.

I looked into both of these people's faces trying to find what it was that made these people love them. I could not figure it out for the life of me. Who had they been? And what happened? I can understand trying and failing. But I cannot understand looking into the eyes of your loved one and seeing the desperation I saw in both of these men and not wanting to change at all. The selfishness in them made me sick. It didn't change the way I cared for them but it just felt... bad. Like there was an anger in me for them that I really felt uncomfortable with. Chances are that these women will both kill themselves with their behavior one of these days. An awful part of me felt like it would be better for their loved ones if they went ahead and did it.

Is this normal? Am I putting too much on them? And is it even fair for me to compare my problems with theirs? This job sneaks up on me so bad some days.

[Click HERE to read more amazing blog entries over at New Nurse, in the Hood.]

Sunday, September 19, 2010

Laughing Babies, My Heroes


What Is Anatidaephobia?

Anatidaephobia is defined as a pervasive, irrational fear that one is being watched by a duck. The anatidaephobic individual fears that no matter where they are or what they are doing, a duck watches.

Anatidaephobia is derived from the Greek word "anatidae", meaning ducks, geese or swans and "phobos" meaning fear.

What Causes Anatidaephobia?

As with all phobias, the person coping with Anatidaephobia has experienced a real-life trauma. For the anatidaephobic individual, this trauma most likely occurred during childhood.

Perhaps the individual was intensely frightened by some species of water fowl. Geese and swans are relatively well known for their aggressive tendencies and perhaps the anatidaephobic person was actually bitten or flapped at. Of course, the Far Side comics did little to minimize the fear of being watched by a duck.

While we may be tempted to smile at the memory of those comics or at the mental image of being watched by a duck, for the anatidaephobic person, that fear is uncontrollable. Whatever the cause, the anatidaephobic person can experience emotional turmoil and anxiety that is completely disruptive to daily functioning.

What Are the Symptoms of Anatidaephobia?

The symptoms of Anatidaephobia vary from person to person. Some people, when confronted with their fear, may feel slightly uncomfortable, become nauseated or begin to perspire. Others are so severely compromised by this phobia, that they experience crippling anxiety and/or panic attacks.

Other symptoms of Anatidaephobia can include:

•A Dry Mouth
•Gasping or Shortness of Breath
•Muscle Tension
•Overall Trembling
•Feeling Out of Control
•Feeling Trapped and Unable to Escape
•Overwhelming Feeling of Impending Disaster

How Is Anatidaephobia Diagnosed?

The vast majority of cases of Anatidaephobia are self-diagnosed. The individual realizes that their fear of being watched by a duck is irrational and is severely interfering with their ability to function on a daily basis.

The anatidaephobic person may then discuss their fears with their doctor. Typically the doctor will not assign a diagnosis of Anatidaephobia based on that initial discussion. More routinely, after ruling out any physical
reasons for the phobia, the doctor will refer the individual to a mental health professional for further evaluation and assessment.

How Is Anatidaephobia Treated?

When the fear that a duck is watching becomes so intense as to disrupt an individual's daily functioning, there are a number of ways to treat Anatidaephobia. These can include:

•Talking to the primary physician who can refer the person to a therapist who specifically treats phobias.
•Traditional "talk" therapy that will assist the person to identify and control their fear.
•Self-help techniques.
•Support groups with other people coping with this phobia.
•Cognitive Behavioral Therapy or Desensitization Therapy.
•Exposure Therapy.
•Relaxation techniques such as deep breathing or meditation.
•In the most extreme cases of Anatidaephobia, anti-anxiety medication can be prescribed.

Anatidaephobia is an intense, irrational fear that one is being watched by a duck. Sometimes that fear can become so intense as to completely stop a person's ability to maintain daily functioning. Unchecked, Anatidaephobia can become a debilitating condition that interferes with the person's social life, their personal life and job responsibilities. Untreated, Anatidaephobia touches every aspect of a person's life.