Nursing School Probies Had a Rough Initiation

Right this way to the swimming pool!

First year hospital   diploma nursing students were affectionately referred to as "probies" which was short hand for probationer. Probies had a rough life and were at the mercy of junior and senior nursing students for their first 6 weeks. Some of the more benign pranks inflicted on the  hapless probies were scavenger hunts to central supply for things like fallopian tubes or enema nozzles and  getting doused with water blasted from an asepto syringe.

Some of the initiation shenanigans were a bit shocking and proved to me that estrogen could be just as potent as testosterone when it came to fueling hijinks aimed at demeaning innocent victims. Groups of hospital hardened young women possessed a mystical herd strength fueled by their clinical nursing experiences and were eager to share the misery with novices. Somehow, the girls who were the most faint-hearted became the most aggressive tormentors.

 Nursing was emotionally and physically challenging and the initiation was designed to weed out the more faint of heart. Steel plating was a prerequisite for the rigors of vintage hospital nursing.

Many hospital nursing schools in Chicago  had beautiful indoor swimming pools. Cook County Hospital had one of the fanciest which  resembled a Roman bath complete with marble columns. What a contrast to the stark Nightengale wards packed to the gills with suffering, impoverished patients. Luxury in the midst of poverty always rankled my hackles.

Unbeknownst to probies, our hospital lacked a swimming pool but did have an old fashioned exterior  fire escape tube connected to the second floor freshman dormitory on one end and the great outdoors on the other. In the event of a fire, the fleeing victims opened the double doors to the tube and flung themselves into the awaiting platform that quickly transitioned into a steep descent. Gravity did the rest as the victim flew through the tortuous tube at breakneck velocity landing, hopefully, safely on the outside.

Junior and senior students knew how to grease the skids, so to speak, by applying pilfered bone wax to the inclined tube's interior with ABD dressing pads. This made the descent even more terrifying, especially to the unexpecting probies.

The probie trap was baited by covering the EMERGENCY FIRE EXIT sign on the escape tube's entrance with an ordinary sheet and substituting it with a sign clearly stating: SWIMMING POOL OPEN. The deception was further enhanced by soaking a washcloth with Clorox and tossing it just inside the opening to the tortuous tube. The tortuous tube even smelled like a swimming pool.

"O.K. probbies it's time for a group swim," was the battle cry as the doors to the cleverly disguised fire escape were gleefully swung open. As the probies made their sudden descent a satisfying ( at least to the juniors and senior students,) cacophony of shrieks and screams emerged from the tortuous tubes. Any probbie further back in the line up was advised the screams were in good fun and initiatd by the cold water in the pool.

A Dubious Award for Bovie Smoke Control

There is a cornucopia of awards for modern day nurses. I've previously blogged about this trend which seems to have proliferated to the point of ridiculousness. An organization supposedly representing operating room nurses is now offering an award for an expensive system that attempts to contain the smoke liberated by the cauterization of human tissue. They  have "partnered" with a commercial entity that manufactures these devices. The coveted award is called "Go Clear," and there are gold, silver, and bronze permutations. I can visualize the winners standing on a podium resembling an OR table in their AORN approved bouffant head coverings looking more like chumps than champs.  Any nurse that had the unmitigated gall to seek personal enrichment by huckstering anything by enticing folks with awards would have been shown the door in a vintage hospital.

After a cursory review of the literature, I found there is little in the way of hard science to prove Bovie smoke is harmful and no published randomized trials. Sure it contains some nasty substances and most folks find it unpleasant but old OR nurses would laugh in the face of someone selling an expensive toy to "go clear." If Bovie smoke is one of the worse things you smell as a nurse you must be spending too much time sitting in an office and please, don't get me started on nurse office sitters.

OR nurses were so acclimated to Bovie smoke they could correctly identify the type of tissue being cauterized by the scent of cautery smoke and regarded this ability as a badge of honor. Remember that old TV game show, "Name That Tune"  where contestants said they could identify the song in 3 notes or less?  Vintage scrub nurses played a variation of that game by playing "Name That Tissue Smoke."  Pleura was the easy one for me and I could name that tissue in 1 whiff because of the characteristic sweet/sour smell released by the smoke plume.

There are cost effective ways to mitigate Bovie smoke that do not involve the unsavory element of money changing hands. We were conditioned to believe nurses were meant to be poor and efforts toward personal remuneration were sinful. My what a different world today where patients check in and check out of medical office  visits with all the dignity of a Wal Mart Trip. Nurses have more money today but something has been lost in the process. Proud, caring professionals have been rendered mercenary automatons by corporate healthcare.

One of the most efficient Bovie smoke minimization  strategies has presidential overtones and it's appropriately called  the Clinton strategy; don't inhale. Just wait until that perilous  plume dissipates to resume normal respiratory activity. Works every time and doesn't cost a cent.  If you don't inhale it can't hurt you or cause adverse political consequences. Bill was unto something.

Surgical masks are designed to implement a barrier that prevent endogenous operator  bacteria from reaching the surgical site. Masks function both ways and  are also effective filters to block inhalation of Bovie smoke. As proof  I offer the post operative sniff test which involves reversing the mask and thrusting your proboscis dead center into the mask after a long case. Guess what? It smells just like Bovie smoke that's in the mask and not your lungs.

Oldster nurses were frugal by nature and trained to use existing resources to the maximum. If  you are interested in saving your hospital big  money there is post on my blog that explains how to perform a sterile procedure with finger cots. Gloves are not cheap. There is suction available on surgical cases so if you don't care for Bovie smoke just suction away with what you have. Be prepared to be belittled because tolerance of Bovie smoke was an expected virtue and self serving actions like this were seen as a public declaration of your lack of commitment to patient care. Nurses were expected to put themselves in uncomfortable  and self endangering situations. It was all part of being a nurse. A hospital is not Disneyland!

A Remembrance of Nursing Pins Past

The land of the free and the home of the brave was once home to 4,000 diploma schools of nursing  each with their own unique nursing pin. These pins were typically designed by committee and the final version was often a hodge-podge collection of sometimes divergent elements. It was tough for a committee to come up with a consensus for a coherent design.  At my alma matter the pins were the responsibility of the Admissions and Promotions committee and it required weeks of heated discussion to decide if one letter on the pin should be changed to reflect the conversion of our hospital to a "medical center." After much heated debate it was decided to change the "H" which was for hospital to "MC." Nursing pins were sacred symbols and change did not come easily.

Implant something in an adolescent brain while it's developing and it sticks forever. We were brainwashed  conditioned  into believing our pin was the ultimate reward for 3 years of soul crushing labor while  subjected to near constant badgering and belittling by down right mean instructors like Miss Bruiser. That beloved pin had a transcendant element to it that required a compulsory level of reverence. It was the alpha and omega to any 3 year diploma student. The  radiant pin glowing against a pure white background was the first thing your eye settled on when a nurse appeared on the scene and it told the story of a nurse's experience. If only nursing pins could talk.

I spent many hours staring at the cover of RN magazine when their annual nursing pin edition was published. A cover adorned with 30+ pins in glowing color was a feast for any diploma grad's  eye. The most common pin design was a Maltese cross with the schools initials plastered one on top of another over the center. I just loved pins with a singular sculpted design like the  Ravenswood Hospital School of Nursing in Chicago. The pin featured a beautiful version of the Good Samaritan that seemingly glowed in the dark. Wow.. that was one heck of a pin.

Speaking of good samaritanns this unusual pin featuring a beaver really got my attention. Simple, straightforward design at it's best. Beaver's are like nurses; hard working and they have the ability to modify their environment for unexpected needs. Beavers are also continually growing just like me after too much hospital cafeteria food. I really cherish this pin and think it has much better aesthetics than mine which resembles a policeman's badge. While working in psych, I found that it was prudent to remove my pin lest I be confused with an undercover cop.

Another animal themed nursing pin with a serene looking moose in the foreground framed by the hospital's name. I wonder why the moose is gazing in the opposite direction from the beaver. I think it looks better from a nurse's view looking down to have the animal facing the nurse.   The cross in the background forms a lovely backdrop. It takes a moose 3 years to attain adulthood and 3 years for a diploma nurse to graduate; an interesting fact that ties it all together. A moose also has muscular shoulders and nurses acquire the same qualities  after a stint on the orthopedic ward. I admire these two pins because they are straightforward and very pleasing to the eye.

So many pins contain multiple symbolic features that are difficult to decipher. I was admiring the floral design on a friend's pin and was quickly informed they were no ordinary flowers. "That's the Papaverum somniferum plant that is the source for opium," I was told. Her pin was symbolic of the nurse's duty to relieve pain.

It really bothers me when I hear that present day nurses must pay money for their nursing pins. A nursing pin was no ordinary commodity that could be purchased with money. Blood, sweat and tears were how we paid for our pins. The symbolic meaning of a diploma nurse's pin stays with a person forever. I sneak little glances at my pin all the time just to remind myself of who I was am.

Nursing Awards - Emmitt Knows Where They Belong

Proud winners of a nursing award. At least

their trophy has relevance-looks like a bath basin.

When Emmitt Smith, the hall of fame running back for the Dallas  Cowboys received the"Galloping Gobbler" award from John Madden, he knew what to do with it. No pretentious acceptance speeches or bubbly gratitude for a meaningless award.  When Emmitt thought he was off camera that pointless award was unceremoniously deposited in it's rightful place, the garbage can.

It's too bad that some nurses lack Emmitt's judgment and discretion regarding meaningless, phoney baloney awards worth their weight in wormwood. Hospitals of today often have a shrine-like  area where garish gold plaques are displayed honoring a select group of nurses. Nothing wrong with this concept if it gives recognition to deserving nurses who have honed their technical skills to help patients, but frequently the awarding entity is far removed from patient care and  has little insight into bedside nursing excellence or comforting patients. Physicians, administrative nurses (if you could even call them nurses,) insurance companies, and the nurse academic/ office sitter complex all have very minimal working knowledge of what makes a good bedside nurse. Doctors just love nurses who know their rightful place and never question orders or call them up in the middle of the night. Administrative types view nursing through the distorted lens of corporate goals and please don't get me started on office sitters of any permutation. Discretion is the better part of valor, I keep muttering to myself. Sometimes it's better to keep my foolish mouth shut.

We certainly had nothing like this when I was a nurse. Our instructors and mentors (if you could call them that) always stressed that the satisfaction of helping patients recover from injury or ailment had to come from within. If a trauma patient walked out the door or a patient's pain was relieved, you did a good job and that was your reward.  In their mind nursing was a calling and required self motivation which was also a good reason for paying nurses a poverty wage. If you are looking for good time Charley back slapping rewards or big money you are in the wrong profession.

As a public service the OFRN institute for nursing practice is going to separate the wheat from the chaff when it comes to awards for nurses. If you notice any of the following words or combination of words in the criteria or award title, its of  dubious distinction: influential, pinnacle, showcase,  emerging, distinguished, rising star, engagement, transformational, breakthrough,  paradigm, cameo, illustrious, or eminent. It's time to go above and beyond or even eschew these  nonsensical awards. It's time to take a lesson from Emmitt Smith and deposit these chucklehead awards in their rightful place.

Here are a few worthy nursing awards that have straightforward criteria and reflect nursing as it's clinically practiced, untainted from pie-in-the-sky bafflegab.

The Last Nurse Standing Award... An endurance award of sorts to the scrub nurse that can hang in there on one of those knee aching  surgeries that start before sunrise and end after sunset and I'm talking about Chicago - not the Arctic circle. My personal best is close to 8 hours on a complex trauma and that's not even worth mentioning because  my mentor Nancy went for close to 12 hours on a Whipple with complications. She deserves a standing ovation and a well deserved trip to the bathroom.

The Stink Finger Statue... Goes to the nurse who never shied away from any mess-you name the body excretion and this nurse gets down to business, sans gloves. I really admired this nurse because almost everyone has an Achilles heal when it comes to messes, mine was that gooey blood/bone chip slurry mess left on the floor of the ortho room after a long,  messy case.  Blood..no problem, bone chips..no problem, but mix them together and the resultant ooze-like  combo brought me to my knees every time. Thanks to Colleen and Gail for bailing me out on this one. You deserve this and remember to refrain from sniffing those fingers.

Venous Access King or Queen...goes to the best IV starter. Bring me your hypovolemic, phlebotic and sclerotic patient and I'll slide that angio cath in faster than you can say central line.

The Sailor Award...goes to the most fluent user of off color language. I usually avoided this one because it resulted in much childhood unpleasantness if caught uttering swearwords, but I  some how felt a sense of relief when others spouted out colorful descriptive language. Nurse  Felix deserves this award for coming up with the u;timate inclusive cuss word (sh++t,f**k.G++d**n it) all in one breath. What more can I say?

Most Likely to Cry...I always admired nurses that could do this. It's better than alcohol or drugs at diffusing sadness. The most I could come up with were a couple of stray tears, but at least I tried.

Most Kind nurse...We all know one of these. This nurse is nice to everyone and always sports an infectious smile that's even visible under a mask. As nurses age this trait seems to decline although I have met a couple of these angels in white who were well into their 60s. Rita you deserve this award if you can stop puffing on that Winston long enough to claim it.

The Walking Wounded...These tough nosed, hardened nurses can work through bone on bone hip joints, unremitting Crohns Disease, or even while on chemo for aggressive cancers. Tough as nails; the primary objective is to die at the bedside with their Clinic Shoes on. I did manage to scrub on a case one day after having impacted wisdom teeth removed and I was never so grateful that it did not involve oral surgery. The pain sharpened my senses, but I would not never,  ever want anyone to work for this award.

A really good nurse will do whatever it takes to help a patient in need not because it's about award procurement, but because it's the right thing to do. The fact that the obsessive pursuit of awards leaves profound deficits in other areas of direct  nursing care is a definite reality. Emmitt got it right.

White Coat Ceremonies for Nurses

I was shocked when I learned a local nursing school was holding a white coat ceremony to honor their students  entry to actual clinical practice. Excuse me, but nurse's have a historical and rich tradition and it has nothing to do with those microorganism infested white coats that those high and mighty  doctors wear.  Did you ever hear the term "white coat hypertension?"  It's called that for a reason. White coats do not communicate the comfort and  caring image that nurses bring to the bedside, especially for cranky oldsters like myself. Let the MDs keep their filthy  white coats. Nurse's have something a whole lot better that has real traditional and symbolic  meaning.

It's called capping and any diploma school graduate can attest to the emotional and spiritual elements of a candlelit capping ceremony. Yes, I know that nurses no longer wear caps, but that is no excuse for abandoning one of the time honored and sacred of  nursing traditions. Delivery personnel no longer utilize horses, but truck drivers continue the tradition of belonging to the Teamsters Union. Priests conduct Mass in electrified buildings, but continue to use candles.

Just because nurses no longer wear caps, it's not OK to abandon decades of tradition. You do not throw the baby out with the bath water and then like a parasite attach one self to a physicians white coat. It's just plain wrong and a slap in the face to oldfoolish RN's like myself. Capping is the name of the ceremony that marks a nurses advancement to actual bedside practice. It's been like that for many decades. Why monkey with a good thing?

Let's see you whippersnapperSNs come up

with a White Coat Ceremoy card that has

the charm of this 1950's gem that cost the
princely sum of 15 cents!

Recent  history shows that nursing , especially you academic types, likes to "borrow" ideas from other professions and incorporate them into a nursing context. What the devil is "nursing research?"
Nurses should be doing clinical based research like physicians, pharmacists, and other health professionals are doing. We  don't hear of "doctor research" or "pharmacist research." It's called clinical research and it's done for patients. Borrowing ideas and traditions from others, especially those that poorly reflect traditional nursing values  leads us down that rabbit hole of lost identity.

Soon we become utilization review nurses or computer   nurses whose only preoccupation is generating business or saving insurance companies money. What distance have  we put between the nurse and bedside? I don't think this is progress.

I apologize for my uncouth ranting, my arthritis is driving me nuts today. I have a few higher minded posts in mind for the future so please be patient. Thanks for reading my foolishness.

Nurse Graduation Day 1968

A true classic. It seems like yesterday! The person recording this must have thought it was a very important event. There were no cell phone video recorders or even cam corders. The person had to use a camera running genuine film through it and synching it to a magnetic sound strip.

I posted "Commencement" back in March specific to my graduation if anyone is interested. It was very similar to video. The closing scene with the lit Nightingale lamps and graduates reciting the pledge was a diploma school universal event. Our instructors always positioned themselves in front of the class during the recitation and at our school it was a tradition that students "accidentally" dripped hot wax from our candles on them. A passive-aggressive payback for 3 years of pure torture. We had our pins and diploma. What could they do except scream?