Be an Asshole. You'll Live Longer.

I love student nurses. They are so bright-eyed and bushy-tailed and absolutely everything is new and exciting to them. When I was first learning how to be a nurse I was always eager to see and do anything I could get my hands on. Drop an NG? Heck yeah! Administer an enema? Bring it on! Empty that ostomy? Kind of gross, but I'll do it. This was not the case with the nursing student I was chosen to precept the other day. He was one of those "you can't teach me anything I don't already know because I work in an ER" types and no critically unstable patient (on a filter, with pressors, and in multi-system organ failure) was going to change his views. News flash buddy, you better learn to drop that attitude real quick or you're gonna get your ass handed to you. You're in nursing school for a reason, you are going to make mistakes, and you will NEVER know everything. Regardless of his blase attitude towards my "day in the life of an ICU nurse" lessons, I was determined to impress upon him at least one morsel of knowledge before the shift was over. So, in light of his pompous attitude, I settled on the words of wisdom that no nursing class will ever teach you: be an asshole and you'll live longer.

I have no statistical data to prove this, however, I do have approximately 6 years of hospital experience under my belt that continues to back my hypothesis time and time again. For some reason unknown to me, the nicest, sweetest people always seem to suffer and die, while the mean, cold-hearted, "I'm gonna call you a bitch every time you walk in the room" patients overcome insurmountable illnesses and survive. I swear to you this is true.

As ICU nurses, we have the honor of becoming "family" to our patients and their loved ones, but with this, we also have the misfortune of baring the weight of their suffering because we want so badly for them to get better and leave the hospital. Most of what I see and do on the daily I would not wish upon my worst enemies and I will never get accustomed to seeing good people suffer.  

On the contrary, I have also been kicked, bitched at, called names, bitten, shit on, and you name it, by some of the most vial patients and family members known to man. (Note: no family member has yet to bite or shit on me... but my career is still young..) You know, the type of people who make your blood boil and make you seriously contemplate inserting a size 48 french foley into their peeper without any lube and without any guilt. These are the people that make a nurse's job a living hell and these, ladies and gentlemen, are the people that live forever. 

One patient that sticks out in my mind was a younger gentleman who nearly died because he decided that since the meds that kept him alive upset his stomach, he just wasn't going to take them anymore. Instead of discussing this issue with his doctor, which would have been a logical thought, he just decided to stop them cold turkey. By the time he entered my care, he had not been taking his meds for at least 3 months. Now, I don't want to place blame here, but as far as I'm concerned, any result from this decision was his own damn fault. Regardless, this man went from vomiting in the ER to maxed out on 3 pressors in less than 24 hours. He was siiiiiiick. The doctors explained to the family how severely ill he was and told them that, although we would do everything to save him, there was a very high likelihood that he was going to die as a result of his actions. Shockingly, family appeared at ease with this decision.

While trying to keep him alive throughout my shift, I couldn't help but eavesdrop on his family's conversations since they almost sounded like an episode of the Maury Povich show. Every member of his family was a little "rough around the edges" and every member of his family also appeared to hate his guts. Usually when someone is dying, families will talk about how much they love said person. Not this boy's family. They held vigil by exchanging stories about how much of an asshole he was and how they couldn't stand him. It was hilarious. (ICU nurses have a twisted sense of humor..) That evening, I passed him on to the night shift nurse, said goodbye to his family, and went on to enjoy my weekend off, fully expecting this man to die within the next few hours. Imagine my shock when I returned a few days later to find him still alive, actually improving, and awake. Completely blew my mind. Just goes to show you that A) you can never predict who is going to "make it" and who is not and B) that assholes, much like cockroaches, can survive just about anything.

There are many other stories that emulate this one and many more patients out there who are making nurses lives a living hell, all the while outliving the kind and caring patients that nurses enjoy. The fact that assholes seem to fair better is not a "rule", but rather an observation I have made over the years. Although being nice gets you special care from the nurses, if I am ever a patient, I think I will purposefully try to be the biggest bitch in an attempt to up my chances of making it out alive.

Sometimes I fall asleep while doing oral care, too... weird pic, yet, mildly funny..