Gadgets
Prologue: A true story1
An acquaintance of your humble author purchased a brand new Chevrolet Corvette some years ago, at about the time when digital dashboards were appearing in the most modern of automobiles. On the morning after the purchase, my friend invited his wife to join him for a spin in the new item. (Yes it was red, and yes this involved one of those midlife “problems” you hear so much about, but that is irrelevant to the matter at hand.) When they were both settled in their comfy leather seats, the fellow attempted to start the car. Not a single blip of a light appeared on the dash. Not a pixel. He used some strong language and tried again. Nada.
At which point his wife delivered a sharp slap to the dash. As if by magic the panel lit up.
“Why did you do that?”
“We do it to the CT-scan at work all the time.”
[Image courtesy of freepik.com]
To look at me, you'd prolly not guess my line of work. I mean, the guy lookin' at me in the mirror reminds me of the fellows, and they're pretty much mostly fellows, with the dollies. Y'know, the ones you see rollin' big stacks of beer boxes or kegs or Co-cola or what have you, from a delivery truck parked blockin' traffic downtown into some juke joint or another. They're usually in pretty good shape. The guys, I mean.
Or maybe you'd think I work for UPS. Not so much FedEx, cuz they generally deliver little white envelopes, and to tell it true, which I do, they just don't get enough exercise.
Early middle age, no gray yet, carry myself pretty well, barbered and what not. But no, the only deliveries in which I have had the opportunity to be employed involved wee-wads, not boxes or barrels. I'm an R.N., in intensive these past seven years, so the last of the wee-wads was a good while back.
I see the look of surprise. Even in this somewhat “enlightened” era, when most people think “nurse” they think “woman,” and truth be told (see above) most of my workmates are of the feminine persuasion. Don't think they aren't glad I'm around!
“Why?” you ask, and no wonder. You prolly already got an impression that it ain't my way with words, and what you see ain't anything like a movie star, though I don't think I'm too hard to look at, and I do pretty good with dark jokes. You need some black humor to keep the day uplifted when most of the clientele have one foot slippin'. Grave-wise.
So they like me okay but prolly when you get to the bottom line, it comes down to strong arms as number one. Some of the patients are on the large size. Make that “a lot.” You can hear about the fat crisis on the news but in the hospital the food giants are up close and personal. You people don't walk enough, and you can quote me on that. You're way too deep into the Oreos and chips. And dammit, ice cream.
So when we need to move one of 'em, and you can't find an orderly to save your bohunkus which is pretty often in my professional experience, I'm there to heft the dead weight from bed to gurney or whatever. And I don't mind, cuz I'm helpful by nature, and it don't feel bad to be appreciated.
But that's only the big picture (see above). What I don't get so much credit for is what I do on the down-low. I'm kind of an inventor-type.
I see that look of surprise again, but what you see ain't always what you get. You were thinkin' “Okay, he's a nurse, but really just some average galoot.” I don't blame you, I do own a mirror. (See above.)
Here's the thing. Modern medical comes down to drugs and gadgets. I leave the dope to the docs. Too much, too little, I have my opinion, but no second guessin' from this worker bee. If they wanna make an opioid problem, let 'em, I say.
But gadgets is a whole nuther ball of wax. Y'know I was fixin' my bike when I wasn't much past a wee-wad, and then stereos and cars, natch. Learnt tools from my Daddy, a real Mr. Fixit. The first time I got inside a computer was like a light bulb moment. It's just parts! Made a pretty good side job in nursin' school, fixin' the other kids' units, which mostly bein' PCs were always needin' a patch. Or a virus sweep. Those gizmos had more diseases than the big palookas on my ward.
So, what's the biggest problem for a nurse in a hospital? Go ahead, guess. I'm patient. No, not that. Not that either. Use your imagination!
The call button. The call button.
Think about it. You're in the station, starin' at a screen, catchin' up with your buds on FB, or checkin' out the latest kitten vid, maybe somethin' NSFW which is usually pretty interestin', and the buzzer beeps and the light blinks. Room 703. Like for the umpteenth time and you're only at halfway on your shift.
Annoyin' ain't the half of it. What's worse, if your supervisor's on hand, you've got to get up and go.
Can you say “protocol?”
So I come up with a patch. Did it one night—did I say I work third? The whole system routes through one unit. Bingo! Now the signal only comes through after at least five squeezes of the ole butteroonee, and randomized to boot. Sometimes it takes seven or thirteen.
Now puhleeze don't think ill of me. I'm not one to put lives in danger. I'm a nurse, remember? After squeeze three the patient's vitals pop up in upper corner of the station screen, so the duty nurse can tell at a glance whether the occupant is flat-lining or what-not, and go back to the chat or whatever. The super thinks this is a great improvement, which it is in the matter of data, but she don't know about the delay trick. What she don't know won't hurt her is my rule. Hey, it keeps the troops happy.
So in every room there's a display with all the vitals, and that turns out to be problem number two. Some of you got that answer right. Go to the head of the class, or whatever.
So here you have a sick puppy with nothin' to do but look at screens, either the TV or the vitals and if you own a TV you know the choice is pretty obvious. So some little wiggle, I mean these people memorize the display pretty quick, it bein' their own selves what are on the line, and some little wiggle and they're all over the call button. Nothin' better to do than to second guess the medical establishment.
(Then why did you come to a hospital in the first place?)
Nuther easy fix. I made it so the displays in the rooms all show everythin' totally norm, except when a medical professional like yours truly enters the space and hits “Refresh.” The screen at the station shows the real dope. (What were you thinking??) But the one in the room is set to keep the customers calm. I consider that the gadget version of “bedside manners.” My super knows about this one and put me in for a raise on account of. This isn't her first rodeo neither.
And don't get me started on rodeos.
By rights they oughta be called “boneos.” Every year when that circus rolls through we get broke arms, legs, ribs, hands, feet and what not. Of course, in my ward we only handle the major skull fractures and the spinals. Ain't no way to have fun, as the song had it.
So I do pretty good with some of the tech stuff. But we still have a bunch of gadgets that I can't improve, let alone fix. Like there's the CT down in radiology that shuts down every so often, right in the middle of a scan which is what you'd call the crucial part of the procedure, where the girls figured out that a quick slap brings it back alive. Must be a loose wire, but it beats me.
On the whole, what you can only learn from experience, is not to actually trust the machines. When in doubt, follow your hunch is what. We can get you wired up six ways from Sunday, tubes in and out and all the rest, but honestly (see above) most of that rigamarole is for show and tell. A patient whose gettin' billed ten thou a day wants to believe their gettin' the whole shebang. Bein' charged fifty cents a pop for Kleenex and twenty-five bucks for the keepsake plastic bedpan goes down easier when the room looks like somethin' out of Star Wars or whatever. And the family's the same. They see all this whizzo stuff in the movies and figure they deserve some too. But it's us pros gonna save your bacon, not some programmer in Seattle.
A doc I useta date tole me somethin' she learnt in med school2. At the top end of the pipeline nine out of ten peeps who trot into a doc's office are gonna get better without a lick of medical meddlin'. Figurin' out who really needed a pro was job one. Which is somethin' to think about. I know I do.
Course by the time they slide down to my end of the pipe it's pretty much the other way around. I think about that too.
Naturally, there's the probs out of my regular ball park but on which I have good advice. Some of you got this one right too. Number three actually hasn't been a direct issue for me, bein' a guy, but the nurses of a feminine persuasion used to report it all the time. Once the men patients get past whatever crisis landed them in our hoosegow, some of them get handsy with the ladies.
We call them “Bidens,” as in “We've got another Biden in 715.” The protocol used to be to rebuke firmly and steer clear, often as not try to get one of us guys to cover that joker.
But I come up with a cure, one of those things we share at staff level, but don't share with the supers, though truth is I'm pretty sure they know. And don't mind.
So when one of the ladies answers a call to a known “Biden” she always takes along a pitcher of ice water, about which I assume you can prolly figure out the rest.
Works like a slap on the ole MRI.3
****
NOTE PER FOOTNOTES: Substack starts off with new numbering each time I post a story. But Footnotes in the original book are continuous and often refer back to previous super important stuff. So original Footnote #s are included below in [#]s. Look to earlier posts on my Substack channel as needed.
1 [52] Honest injun, as we used to say when I was a kid. Really truly, no crossies.
2 [53] The author heard this first hand from a recent graduate from a highly respected doctoral program, an intern at the time. I don't make things up!
3 [54] Prey, as it happens, to the same funk as the aforementioned CT.
Copyright© 2019, Cecil Bothwell, All rights reserved