Dearest mommie.

By: Debbie Moore-Black, RN

She lay listless in bed.
Agonal breathing.
Only 63 years old.

Before stage 4 colon cancer totally claimed my mother, she chose to come home. Her bedroom. And she’d stare for one more time out her window, at her dogwood trees. That symbolized to her the petals with the blood of Jesus. So they said.

A once vibrant Italian Catholic and mother of 4. She was the perfect wife of an IBM executive.

But it was all for show. The large house, the lake house with a matching boat. The private Catholic school. But we the children faced years and years of neglect, verbal abuse and demands.

“You’re dumb and stupid and fat”.
“You will be a nurse.” “You can not go off to college.” “You will stay in this house while in nursing school.”.

As I literally watched my daddy, lose his executive jobs, lose his lake house, while becoming a non-functional alcoholic. Bumping into the walls at night after he drank his daily gallon of wine, intermittently splashed with a case of beer. Once I got my driver’s license, I had to retrieve that for him. Every other day. The cases of beer. Humiliating.

Mother had the finest clothes. Designer clothes. She didn’t work. She had a housekeeper. And unless us children could sew an outfit for public school (after we graduated from our uniformed private Catholic school), we were doomed.

I couldn’t sew.
I was that laughing stock.
The big house showed wealth and prosper. The truth was inside. Dark, curtains drawn and constant ridicule.

Somehow, maybe through our guardian angels, we became a masters degree level teacher, a CRNA, a critical care nurse, and a civil engineer. But we silently carried our wounds of childhood throughout our adult life.

We took turns taking care of our dying mother. It was my turn. And my 2 year old daughter would stand next to me as she watched me reposition my mother in bed. Clean my mother’s bowel movement in bed. Her urinated sheets, in bed.

I felt some type of obligation as a daughter. But any type of love for mother was gone.
I was just a functioning zombie.
Cleaning her bowel movements over and over again and revisiting in my mind, the neglect and ridicule and the constant degradation of my fragile ego.

Mother’s best friend came to visit her often. She was given permission to give mother the “last rites”. She slowly placed a half dollar size host in my mother’s mouth.

My one sister yelled, “Don’t do it, she’ll aspirate on the communion host!” But mom’s friend felt obligated to fulfill this ritual. So she gave mom, “the body of Christ”

And as predicted, mom coughed, and gagged and aspirated and spit out some of the host that lay on the sheets. Now…what do you do with the remainder of the host? The splattered out “body of Christ” spit out over the sheets.

Rituals.

The hospice nurse stood by.
Administering minute doses of subcutaneous morphine. Enough that would never be enough.
But my secret hero, my sister-like friend told mom, “you can’t die tomorrow. Tomorrow is Friday 13th. That’s bad luck. And you can’t die on Sunday, because that’s Easter Sunday and the Catholic Church won’t bury you on Easter Sunday. So if you don’t die today, Thursday, they’ll have to keep you in a refrigerated morgue until Monday.”

Rituals.

Therefore, today, is the day you’ll have to die. Which happened to be mom’s daughter’s birthday. The twins.

Rituals.

And so with the protest from the hospice nurse, mother was criss- crossed with Fentanyl patches. Because the subq morphine did nothing.

Her breathing became shallow and agonal.
Her once plump body wasting away, as her wedding ring fell off her finger onto the hard wood floors.

A deafening sound.
A sound of surrender.
A sound of no more pain.
A sound of never again: negligence and torment and verbal abuse…..

But the echoes of abuse live on….
The extinction of our lifelong sadness… of a pretend fairytale life….comes back to all of us randomly…when we least expect it.

The Zoom Nursing Interview

By: Debbie Moore-Black, RN

I have dedicated 35 years of my life as a nurse: in the ICU for 33 years and behavioral health/intensive management for the last two.

I thought it would be time to take a break from ICU nursing. Surely behavioral health would be a lot easier — kind of a slide into my near-future retirement.

I entered into the land of psychotics and schizophrenics, bipolar, homeless, dangerous patients from prison, like those serving time for killing people or assaulting them. Then there were the non-compliants that looked away from treatment, therapy and medications — the revolving door.

It wasn’t the Land of Oz. We weren’t in Kansas anymore.

I’ve enjoyed these quite interesting last two years. What an intriguing nursing profession. And I’ve learned a lot.

First: to be kind and gentle and listen and care. Your compassion for that person may be all that patient has received in a very long time.

Second: I also learned that I absolutely can’t tolerate nursing bullies. There always seems to be one cruel nurse in the bunch. I don’t do well with them. I avoid them. I definitely can’t confront them. They scare me, but they also make me angry. Because I know the fault is not in me but in them. I try to analyze this kind of nurse. Did she grow up with such anger, maybe neglect, and she’s acting out? And when management turns a blind eye to this behavior, the environment becomes toxic.

I valued my safety and the safety of the staff and the patients. And when management chose the budget over safety — even though they professed to be “the best” after seeing and hearing of dangerous incidents one after the other — I knew I’d have to look for a job yet again.

Maybe I’d go back to ICU at a smaller hospital with lower acuities. Maybe I’d find myself as an ER behavioral health professional who provided 24/7 public safety officers.

I applied to three different positions.

I’m 65 years old. And I have 10 months left before retirement.

I would think with my 33 years of ICU experience, my last few years in behavioral health/intensive management, that I’d be an easy “yes.”

But all three turned me down.

Was it because I only had 10 months left to retire?

Or was it because I lost my “filter”?

I lost the “right” things to say during an interview.

Question: “What are your long-term goals?”

My answer: To take a long, much-needed vacation to the Bahamas. I deserve it (chuckle).

Question: “What would you bring to the table here in the ER with all of your expertise?”

My answer: First, I’d buy you a brand new coffee pot! I have to have my coffee. And you all definitely need a better brand!

I thought they’d catch my humor?

Obviously, they did not.

I was honest, though. Sometimes they don’t want you to be honest.

But during this Zoom interview, I also added my years of experience, my current, and active certifications, that I was a killer at starting IVs and that the most important lesson to ever learn or carry out with patients is kindness and sincerity.

Both of these go a long way. And whether a patient is in the ICU, ER or behavioral health, they’ve all been injured, mentally, physically or both.

In my long years of being a nurse, kindness has to be at the top.

I was turned down, one after the other. I felt my self-worth had hit rock bottom. I use to be this “famous” ICU nurse, and now I’m this fading 65 year old.

So here I stand. 10 months to go. Maybe these other jobs just weren’t meant to be.

Maybe I can no longer filter out what they want to hear.

I’ve had 35 years of incredible memories, incredible nurses and physicians and respiratory therapists, all of us connecting the dots in life through work, through our “grits therapy breakfast,” and through our trauma and triumphs in nursing and our own lives.

I guess I’m just supposed to “stay put” until the winds blow me into my next journey in life.

……………

Originally published at KevinMD.com

The Sacred Silence

By Debbie Moore-Black, RN

Mom wept silently as she stared at her dead daughter — quiet, near catatonic. I was prepared for a sharp scream.

But she sat there quietly. She was staring at her beautiful but lifeless daughter.

Young with long black hair and 21 years old. She was mom’s pride and joy.

The daughter got into yet another fight with her boyfriend. They were both in college dorm apartments. She couldn’t stand the screaming anymore.

As a little girl, her dad would scream at her mom. The screaming always haunted her.

She remembered hiding under her bed, hugging her teddy bear, crying. Make them stop, make them stop!

Her boyfriend wouldn’t stop screaming. She opened the window in her small apartment to breathe in fresh air. And in an irrational decision, she jumped out the window — five stories down.

The boyfriend called 911. He was in disbelief and packed a night bag of clothes for her with pajamas and socks. And he followed the ambulance to the ER.

The trauma team was activated, called overhead. STAT. Blaring out: “Code trauma ER, code trauma ER.”

She laid lifeless on the stretcher. Her face was perfect. But her organs were destroyed.

Carefully intubated, they rushed her up to the surgical trauma ICU.
And she was mine.

I looked at her and knew.

I immediately said to the trauma surgeon, “She’s dead.”

The trauma physician said, “I know, I know, but we have to try. We’ll insert a few chest tubes. Maybe a pneumothorax.”

His residents stood by and watched this trauma team work quickly and meticulously.

I hooked the chest tubes up to suction — IV, normal salines flowing rapidly through her veins.

No response. No BP. No pulse. No respirations. It was just a vacant stare that left this earth 30 minutes ago.

And the trauma surgeon, after placing bilateral chest tubes, pronounced her death.

The police went to her mother’s house to bring her mom in.

I never did well with young people. They always broke my heart.

But I was preparing for the mother to be hysterical.

I was prepared to hear a blood-curdling scream.

The mom walked in slowly.

She sat in the chair I provided her. She was staring at her daughter. She sat silently. Not a word. Not a scream. Almost catatonic.

Her beautiful baby girl.

Gone forever.

The mom stayed for one hour. I approached her but didn’t say a word.

It was a sacred silence.

I put my hand on her shoulder. She reached for my hand with her trembling hands. Holding my hand she silently wept.

I wept also.

After one year working in this surgical-trauma ICU, I swore I saw it all. But my heart couldn’t take it anymore.

My steel heart had crushed into a thousand pieces.

…………………………………………………………………………………..

Originally published at KevinMD.com

Tears from heaven: a nurse’s tribue to Dr. Robert Lesslie

By: Debbie Moore-Black, RN

Recently, a former NFL football player, Phillip Adams, murdered Dr. Robert Lesslie, his wife, his two grandchildren ages 5 and 9, an air conditioning appliance man, and critically injured a second man. The NFL player had gunned down these innocent people. And then, he left and went to his parent’s house (who lived on the same road), and after hours of the SWAT team begging this man to surrender, he shot and killed himself in the head.

We don’t know why this happened. We do not know the motive. This story continues to unravel.

I met this physician years ago, as I was working on my RN and doing my clinicals at this local hospital. Dr. Robert Lesslie was famous, especially to us students. He was a brilliant physician, cool and calm in any emergency situation. He was the chief of emergency services at this local hospital, and eventually, he started his own free-standing emergency medical centers and added hospice and palliative care.

Beyond being the best ER physician you would ever meet, he was also kind and compassionate to others. We, the nursing students, were just little minions at the time, but you wouldn’t know it to him. If you were lucky to meet him, you would be met by a firm handshake, a sparkle in his eyes, and a challenge to all of us to study and become the best person, the best nurse, the best paramedic, the best respiratory therapist ever.

Beyond being a physician, a husband, a father of four and several grandchildren, his kaleidoscope of kindness and gratitude of caring and contributing freely to non-profit agencies of people in need; he and his wife were strong members of their local church. Proud of his Christianity, endless love for his Savior.

He once wrote the book, Angels in the ER.

We can’t comprehend senseless tragedies. We can’t explain what goes on in a person’s mind to gun down four adults and two small children.
Dr. Robert Lesslie wrote of the day he would meet his Maker. A perfect heaven and reunion with his mother and father and grandparents. A beautiful masterpiece in the heavens.

We do not know what goes on with tormented souls to end other lives and to end their own life.

We do not know the hour of our death.

It was an honor and privilege to have met you, Dr. Lesslie, 37 years ago. You inspired me and challenged me to go further, and to not only help others medically but to do so with kindness in our hearts.

I will always remember that sparkle in your eyes that told me to not give up.

Today it rained.

Tears from heaven.

……….

Originally published at Kevinmd.com

A death in the work family

By: Debbie Moore-Black, RN

At an early age, Tasha remembered looking up to her mama dressed in a crisp white uniform and a nursing cap placed perfectly upon her head — one bobby pin at a time. Tasha learned what sacrifice, responsibility, and dedication were all about.

She also knew her mama’s love for the nursing profession.

When Tasha was four years old, she used to say: “One day, I will be a nurse just like you, mama!”

Tasha excelled in academics. She loved chemistry, biology, microbiology, anatomy, physiology and psychology. By the time Tasha finished all of her academic requirements in college, she proudly held up the letter that came in the mail. The letter of acceptance into nursing school.

Her dream came true.

Tasha proudly displayed her BSN diploma. Her true love was behavioral health. She wanted to help people in a time of distress and dysfunction — a time when patients felt their life and desire to live started to unravel.

Tasha knew how to deescalate the one in a rage. She knew how to calm the sobbing tears of a lost soul. She could comfort and listen with a calming spirit. If she wasn’t holding their hand, her eyes told them that she cared. And sometimes, that’s all these patients needed — someone to listen, someone to care.

Tasha and her mama were a team. Joined at the hip, and as Tasha’s mom grew older, Tasha was there to take care of her.

Tasha also took care of her behavioral health unit. She considered the staff her “other” family … her second family. The staff grew to love her. Her endless generosity often meant providing the entire staff with a full course meal. Sometimes it was on a random day, sometimes an Easter dinner, Christmas or New Years’ Day. Tasha was full of love. And her staff loved her dearly.

Tasha put her scrubs on. Day three of 12-hour shifts.

She felt a little “off” on this day. Lots of “indigestion.” She felt weak with some shortness of breath. But she knew her ongoing indigestion well. Her weakness and shortness of breath had to be attributed to her third day at work.

Tasha clocked in. Ready to go, looking forward to a nice long weekend off.

She told a fellow RN, though, that she wasn’t quite up to par on this day. But she knew she could make it through these next 12 hours.

At 17:30 (5:30 p.m.) Tasha was outside of the behavioral health unit talking to a patient’s family member and giving them an update. As Tasha was talking, she stopped, slumped over and fell to the floor.

The family member frantically screamed for help. The staff arrived, a code blue was called, and CPR was initiated immediately.

The code blue team hooked her up to the EKG monitor. Ventricular fibrillation.

A nurse yelled out: “Shocking … all clear … shocking again!”

And after almost two hours of coding Tasha, they couldn’t bring her back.

The physician on the code team pronounced her death.

Our Tasha: Our vibrant, spectacular Tasha was not coming back.

The staff felt lost and broken.

EAP and chaplains set up counseling sessions by Zoom. A poster was placed in the unit by a fellow nurse with pictures of Tasha at restaurants with her staff “family.” Pictures of Tasha at the full-course meals she’d bring into work and of her laughing till her belly hurt. Of Tasha and her mama.

But our behavioral health unit felt as if Tasha’s death had sucked all of the energy out of everyone.

Many people attended her funeral. Nurses, psychiatrists, technicians — her second family. Sullen. Sad. Lost. Broken.

And on this crisp, clear blue sky day, tears flowed from all.

The mahogany casket stood still, shining in the sun with brilliant purple flowers on top. Her favorite color.

And her mama in her wheelchair watched as they lowered her only child, her only daughter, into the ground.

One friend strummed slowly on his guitar.

“How great thou art…”

42 years old.

It won’t happen to me.

It’s just indigestion.

Denial.

Cardiac arrest. 100 percent LAD.

We bowed our heads as the preacher stretched his arms out, looking up to the heavens:

“Thy Kingdom come.

Thy Will be done.”

Originally published on KevinMD.com

A beloved COVID ICU patient turns to comfort care

By: Debbie Moore-Black, RN

Everyone loved Mrs. Maria. She was everyone’s mom, grandma, teacher.

Maria grew up in poverty. Though her family was poor, she knew her parents and siblings loved her and loved each other. But the one thing she knew her passion was at was school. Every morning she couldn’t wait to go to school and learn more. And she knew one day she would be a teacher.

Throughout the years, Maria excelled in school and became the valedictorian of her high school. Her grades and civic participation landed her a scholarship to college. She became that loving teacher. The one we all remember. The one that challenges you to do your best. The one that charged you with energy that you didn’t think you had.

Through the years, she married, had three children, and eventually became a grandmother. Her children and grandchildren loved her. She was their comfort, their love, their wrap-around teddy bear. The neighborhood loved her. The community loved her. And she progressed to a master’s degree and then a doctorate in education.

She led her community as the supervisor of the county schools. COVID hit this community hard. This city. This state. And though Maria wore her masks and encouraged all to wear masks and social distance, the country’s school systems became difficult. Virtual/Zoom courses were created and soon the established school system became riddled with gaps and unsureness on how to continue keeping school open.

Maria came down with a cough. A persistent cough. And then a temperature. And when she became short of breath, she knew. Her family drove her to the hospital. Her oxygen saturation was dropping progressively.

As she entered ICU, the intensivist had a careful talk with one family member and with Maria. They would choose to intubate her. Ventilator, central line, arterial line, then came the Levophed and vasopressin drips for her blood pressure that kept dropping. Every day, every hour was a new evaluation of her oxygenation. Her O2 would vary. One day was good; we’re gonna make it. The next day was horrid. FiO2 increased, Ativan and morphine added. Wrist restraints to avoid potential extubation.

And the nurses came in, gowned, gloved, face masks and face shields. Turning and repositioning Maria … and all of the other COVID patients.

The nurses knew. They knew it was a matter of time.

When they had to prone Maria, they knew it was a last-ditch effort. Her kidneys were failing. Dialysis was started. And Covid ravaged her body. Her organs, one by one, shutting down. Lungs, kidneys, brain bleeds …. gasping, asynchronous with the ventilator … and Maria could not be helped, no matter what we did.

We also loved Maria. We have loved them all. They are not a number. They are a person, a mom, a dad, a sister, a brother, a grandmother, or a grandfather.

The neighborhood showed up at Maria’s house. Candles lit. Showing their love and respect for a great leader. A great mother and grandmother to all. A great teacher. A great doctor of education.

The nurses gathered around Maria as the ventilator was pulled. The family via video said their goodbyes.

“We love you, grandma.”

“We love you, momma.”

Comfort care. Occasional morphine for pain. And we held Dr. Maria’s hand with our latex gloves on. Masked and faceless … but our hearts were there. Melting. Tears.

Fly high, our angel.

Fly high.

Originally published at KevinMD.com

Getting old and the truth about Alzheimer’s

By Debbie Moore-Black, RN

Her son went to visit her at her house of 52 years. The sound in the bathroom indicated that the faucet in the tub was running…. And overflowing onto the floor. A series of events piled one on top of the other. A totaled car, candles burning in the house haphazardly, repetitive questions mentioned 5 minutes apart… The same questions over and over again… Hugging her granddaughter but not remembering her name….

And we knew it was time to place her in a safe, secure atmosphere as An Assisted Living Center. Ruthie went on the tour and loved it! Lots of ‘happy people’, helpful people, energy, serenity, projects, cooking, dining, church, outings, friendship, exercise, tomato gardens….it all seemed like a country club paradise!! And Ruthie told the man in the suit and tie, ‘I’m loaded, sign me up’.

She was ‘loaded’ for 1970’s standards, but Assisted Living Centers easily cost $3500-$5000 per MONTH. And her lifelong saving would easily become diminished after 2+ months. After her son did much homework and inquiring, he found out that Medicaid could kick in, depending on the facility and help after her bank account dwindled down to $2500.

Her son, Terrence, made it happen.

Her last day at her home, suitcases packed. 52 years of living in the same house, lots of memories in this two bedroom, one bath house…. Raising her two boys, middle school, high school, proms, watching her one son go off to college during the Vietnam War, watching her sons walk away from their strict Baptist teachings, One son, married twice, the other son married three times, her husband, of 22 years, walking out that door for another woman, one son ending his life…. Lots of emotions in those walls…. If those walls could talk….

And Ruthie teared up, this was her home, her safe place, her castle, and she had to walk away from it. She searched around desperately seeking her trinkets that were reminders of her life, pictures of yesteryear, cups, plates, clocks, all to be minimized now into one bedroom in this country club estate she would enter.

We all choked up, and I couldn’t help but reflect, all the times I’d sleep in her empty bedroom from nightshift because my little kids wouldn’t let me sleep at our home! And I’d wake up to a tomato sandwich and homemade vegetable soup and the famous ‘Granny Ruthie’s tea….

It’s hard to say goodbye, and to start a new life that tells you that you are near the finish line… She finally put her shoes and socks on, after we asked her to do so six times, she took one more look in her family room, her favorite chair, her fancy living room that was reserved only for the church folk on Sunday’s… And she took her final framed photographs with her… Her pride and joy… Her two sons… One still attentive and alive, the other one .. Gone forever….

We loaded everything up in the car and sadly walked away from that life.

Maybe one of the saddest things I’ve had to deal with, because the truth is… This is all way too close to home, too close to my truth, one day.

(Photo credit: http://www.dojo Image Stream via Google Image search)

A child’s cry through haunting eyes

By Debbie Moore-Black, RN

The emergency department.

A haven for cardiac arrests and gunshot wounds and respiratory distress and overdoses and auto accidents and children’s sniffles and fever and coughs that won’t go away. The ED was easy access to many. And at times, it was an easy fix not to pay the bill upfront or to be anonymous with your problem.

As much as I loved emergency nursing, it was always the children that left me tormented. Buddy with his fractured hip that his parents said he was getting rowdy and fell off the bunk bed. In reality, he was thrown down the stairs by daddy, as his hip fractured.

Jasmine with her beautiful but disheveled hair and her tiny arms dotted with cigarette burns.

Trisha, malnourished with those large eyes black as coal and empty from lack of love. And lack of nutrition. Starving for love. And starving.

Little Susie, sexually assaulted at the age of eight by her momma’s boyfriend. Her souls snatched from her forever.

We kept social services busy. The parents had their situation all explained and planned out. Another accident. Not my fault. He deserved it. Punishment. She flirted with me. The children all had a typical trait. They did not talk. They had no eye contact with the nurse or doctor. They were sullen and withdrawn. And they broke my heart.

They wouldn’t speak, most likely out of fear. But their eyes told everything. The sorrow. The pain. The fear.

This was before the advent of large hospitals having a designated emergency department for pediatrics. We had to be well versed from baby to geriatrics. You can mend the body parts with stents and dialysis and ventilators and medications and surgeries. But you can’t mend the soul of an innocent child who lost his or her voice through abuse. Through neglect.

The social workers and police were our strength and the children’s protection. The parents would scream and shout, “That’s my child! Give him back to me!” as the child would be taken into protective foster custody.

The anguish of a child wanting and needing love from the only person they knew. Their mom. Their dad. Even with incredible abuse, the young children still craved that simple love from a parent. Simple love that they would never have. And a life sentence of pain and anguish and heartache.

My nightmares would not end. I’d wake up in a sweat and a repeated dream of a small child’s hand reaching out to me but never able to grasp his tiny fingers.

Originally published at KevinMD.com

Image credit: shutterstock.com

Create a positive light in nursing

By Debbie Moore-Black, RN

I was an assistant nurse manager (ANM) in a 24 bed ICU in my younger, energetic years. Before that, I was a manager in a very small emergency department. I must say, I loved it. I loved the thrill and the challenge. I was able to work with the Joint Commission; I ordered EKG monitors and defibrillators, any equipment needed for the emergency department. I worked with the health department and social workers. I helped develop protocols and talked to leading cardiologists in the city to create new protocols. I created an information pamphlet area for patients and visitors. I did evaluations and planned scheduling.

I went to the intensive care unit from the emergency department and found my true love. Before long, I graduated to the ANM. I was everyone’s friend. But I was also a rabble-rouser. Should an intensivist not follow a protocol properly, I reported him or her. Should our manager on call be missing in action for 24 hours, I reported her. I was an advocate for the underdog. An advocate for my nurses and nurse-patient ratios. An advocate for the patients.

I sounded the alarms no matter what. I didn’t “pick” my battles because almost everything was my battle.

I learned through the years what was worth fighting for. One of my managers was once deemed “an unassigned leader,” and “this could be good, but …”

Eventually, I was demoted to a staff nurse. I was told that I was not “one of them.”

So now I’m a little over a year until retirement. I don’t want to be a charge nurse; I don’t want to be a leader. I want to do my job as a staff nurse and then drift away into the horizon.

In my 35 years as an ICU nurse, I can sadly say that I have had only one good manager.

But what values did this manager have? She was fair and honest. We respected her greatly. One minute she’d help us with a code blue doing CPR, or passing out emergent medications during the code. Other days in her “spare” time, she helped us clean up a patient, bowel movements and all. If there was bullying in the unit, she squashed it. If a nurse was not up to par, she’d bring him/her into her office. She knew our names. Our children’s names. She’d ask about our sick grandma. She was smart and professional. And not only did we respect and cherish her, the Intensivists and hospitalists loved her also. Our ICU was a well-oiled machine. Sadly, this type of manager has happened only once in my 35-year career.

A new manager comes in with all of his/her titles and degrees. She has a bullwhip in one hand and a microscope in the other. She’s going to kick ass and take names. Every day we hear how terrible we are. How awful we are. That we don’t know our roles. That we perform below mediocrity. There is no light. Morale drops, job satisfaction is at an all-time low, and then comes the nurse turnover. Negativity does not promote a positive reaction. It festers and brews.

So how can a leader, a manager, turn herself around? How do you create a good workforce? Good camaraderie.

Professionalism and accountability? Good question.

We are a family. There’s no way out of it. We live and breathe each other for over 12 hours a day. Besides knowing your clinical skills and critical thinking skills, planning, and budgeting. Evaluate yourself. If you are in this managerial role for control, power, or self-gratification, you’re in it for the wrong reasons. Start with staff relations. Learn and know your staff. Keep communication open. Be honest. Answer your emails. Encourage positive behavior. Give kudos to those who go above and beyond or even those steadfast in good quality nursing and patient care. Encourage education. Ask about their children, their mom or dad.

When you beat us verbally with constant negative ridicule, we crawl under the bed. We underperform. And eventually, we disappear. Delegate, be honest. Open communication. Have goals. Positivity. Correct poor work in privacy. Make nurses want to work for you and with you.

After earning your master’s degrees and PhDs, please take off your mask and remember we’re all human. We’re all in this together. And create a positive light through the tunnel of a very difficult profession called nursing.

Originally published at Kevin MD

COVID doesn’t matter to them. Until it matters.

By Debbie Moore-Black, RN

As I take the pups on their daily walk around the neighborhood. I come upon eight adults outside their houses, near the street, laughing and coughing and sneezing and smoking their cigarettes and huddled up close together.

They didn’t say hello to me, nor did I to them.

But I listened: “I ain’t gettin’ the COVID vaccine, I ain’t going to the hospital. If I get the COVID, I’m staying at home and taking NyQuil, and Robitussin and Ambien … and whatever I can lay my hands on.”

I don’t go out much. Except for my walks, to the grocery store or to work. The local grocery store states mandatory masks, but there are always those that don’t care. As I stood in line recently at the grocery store, distanced myself at the cash register, mask in place, a man comes directly up to my face and coughs on me. And then he begins to laugh.

I don’t know what happened to genuine respect for each other. Common courtesy during this pandemic. Apparently, some people have been convinced that Covid is not real. Or not a big deal. And laughing in the face of science, medicine, and facts.

I guess they don’t know we’re running out of ICU beds and ICU nurses.

And I guess they don’t know we are running out of propofol and dexamethasone. Propofol for intubation and sedation and dexamethasone for the lungs’ inflammation due to the COVID virus attacking the lungs before it makes its way to all other vital organs.

I guess they don’t know about masks or social distancing or the COVID vaccine.

We are running out of basic tube feedings for patients. Running out of plasma. Some city hospitals are full. Our hospital has turned our ICU rooms into two Covid patients to one room. One room that use to be for one patient. Gift shops and conference rooms are converted into COVID beds. Hospital tents are being installed in certain cities.

We are running out of body bags.

The critical care nurses gown and glove and masks and face shields for 12 hours straight. There is no 30-minute break. It is lifesaving ICU room to ICU room. Lifesaving. Or surrendering to another death.

I guess they don’t know that our America now. Today has 356,000 dead people due to COVID.

I guess it doesn’t matter to them until it matters.

Originally published at KevinMD.com