How to Survive the Big House
Posted by realityrounds on June 30, 2009
Nothing reminds me of the dog days of summer like prison movies (?!) and new residents. These young fresh faced souls descend upon our units like new fresh faced inmates. So cute. Here is what this House Mother advises for all the hospital newbies.
How to Survive in the Big House
- The unit secretary is the most important person in the hospital. They are the warden. If you are nice to her, your chances of surviving your stay in the Big House increases. Here is how you get on her good side: Answer the phone. Don’t just stare at it and hope it will go away. Pick it up, answer it nicely, and try to help the voice on the other end. Call the warden by her name, preceded by Ms. “I would be happy to answer that call for you Ms. Smith” If she let’s you call her by her first name, you’re in.
- Medical procedures such as chest tubes and central lines, are inconsequential in your survival in the Big House. Success depends more on your ability to transfer a call and entering your own orders in the computer.
- Nurses, think of us as lifers. Most of us take pride in living in the Big House. It is our second home, and we may not take lightly to the new interlopers with the shorter sentence. We can make your life miserable, or we can make it pleasant. Most of us are just softies with a tough exterior. How to get on our good side: Be respectful. Ask us questions if you do not know something. Do not be a know -it- all, because no one is. Most nurses love to teach, and we would love to share our knowledge on survival to the new inmates. Listen. Help us with the care of patients that you may think is beneath you. Nothing is beneath you, or anyone. Show an interest in us, and everyone, on a personal level. “How was your weekend? Your kids are cute. Did you see Shawshank Redemption?”
- The Medical Director. Think of them as the CEO of the prison system. They also take pride in the Big House, and their unit is the most important. So you are rotating to OB, but really want to spend the rest of your life replacing hips. What do you do? You pretend you love OB. That’s right, pretend. Jump at the chance to do pelvic exams and catch babies. Read, read and read some more. If the OB director asks you a question, do not stare at her like a deer caught in the headlights. Know your shit. If you don’t know, find out. When your shift is over, vent to your friends and other residents about how much you hate OB. Just don’t dare do it in the Big House.
- The Facilities. Be aware that your cell call-room will most likely be smaller than a real life prison cell. If you do not want it smelling like feet and Doritos, be nice to the housekeeper. Clean up after yourself. Your mother does not work here. Wash your own dishes, throw away your take-out containers, don’t leave your wet towels on the floor.
- Bribery. Just like in prison, it is always a good thing. Free diet Cokes, donuts, and chips go a long way.
- The Yard, aka the break room. This is a shared space of lifers, housekeepers, OB directors, secretaries, etc. If it is crowded at lunch time and you are not actively eating….leave. Don’t suck up the oxygen in an already crowded room. Most importantly, give up your seat so all the other hard working inmates can eat their slop while seated.
- The Patients. They are the reason you are doing your time. Remember why you became a doctor. You are mostly young and healthy, and it may be hard to put yourself in their nasty hospital gown and uncomfortable bed. They are most likely more scared of you, than you are of them. Have empathy. Listen.
Treat others how you yourself would want to be treated. An oldie, but a goodie. This will make your sentence a short and pleasant one. It will be worth it in the end.
“Hey you Bastards, I’m still here!” – Papillon (1973)
RR
pinky said
I could not have said it better. Makes sense my alter ego is a 300lb bald gay man in the State Pen. Some folks believe I am actually him and I have made up the L&D nurse persona. Now I understand why it is hard to tell.
maha said
We’re getting our fresh batch of residents this week – can’t wait for the mayhem to start!
lpnmon said
So glad I’m not in a teaching hospital…..
R. May said
lol – I have to agree with you on the unit secretary. (I’m an administrative assistant).
I always tell my friends to be nice to admin people – they know a bit of everything – usually more then their boss – and can make your like pleasant or hell.
I don’t do this for the money – I love my job for it’s power : )
Diana J. said
Hi, there! I can’t find any way to reply to your comment except by posting a comment here…. I apologize if my post was unclear!! I was trying to write in the midst of a toddler-terror whirlwind. Anyhow, I definitely didn’t mean that infant infection/colonization with GBS was beneficial! I meant only that antibiotic treatment for GBS results in a sterile vaginal environment so that the other beneficial bacteria that would otherwise be present could not colonize the baby. I’ve been doing a lot of reading lately (mostly in Midwifery Today, etc.) on the rising rates of diseases (like asthma, etc.) that have been correlated with the increase in GBS antibiotic administration. It’s definitely a difficult issue, because no one wants GBS-infected babies either!! But I find the rates of antibiotic administration (I’ve heard numbers are around 40%) to be rather alarming. Again, I don’t think that the human female is “broken” in that 40% of women need antibiotics to give birth safely. I’d love to hear your thoughts on it, being that you have WAY more knowledge and experience than I do!!!
Cheers! Love the blog!!
realityrounds said
Thanks Diana,
I love your blog also. I have a contact button if you want to post a direct email to me, but it is confusing. I need to re-work some of this blog. Thanks for clearing up the GBBS issue. I have seen some horrible outcomes of infants infected with GBBS and the AAP guidelines on treatment have been lifesaving. Health care in general has an over prescribed attitude for antibiotics. This is especially true in pediatrics. Prophylactic administration of penicillin for GBBS positive moms is not perfect, but it has certainly made a difference in neonatal mortality.
man-nurse said
What is the ratio of GBS colonization to GBS sepsis? That’s what I was wondering in my OB class, but nobody seemed to have any data. I imagine many more babies are colonized than become infected.
I wonder if we could swab and PCR babies instead of giving prophylactic abx (especially to all the moms with unknown GBS status or who refuse testing). I think the reason we don’t do this now is not so much the cost (after all, we’re now doing routine MRSA swabs by the thousands) but the idea that abx are simple to administer and cause no real adverse effects; or rather, that normal skin and gut flora doesn’t really do anything and therefore is not something we need to bother preserving.
Frosty said
Truer words never spoken, especially on unit secretaries and on bribery! A timely, wise post.
man-nurse said
That’s too right about the unit secretary! Everything passes through the unit secretary. I always tried to be nice to new residents as a unit secretary, but I know most UC’s require a fair amount of self-abasement to get on their good side!
Christina said
LOL – so true! I learned in clinicals that the unit secretary was the person who could get you anything or answer any routine question.
Now can you write one of these guides for us poor new nurses just starting our careers? I’ll admit to being a little nervous about my first job.
realityrounds said
Congrats on your new job! What kind of unit will you be working on? That is a good idea for a post. How to survive as a new nurse.
Good luck and enjoy yourself.
Christina said
I’ll be working on a labor/delivery/postpartum floor in a small county hospital. I wanted to either work L&D or NICU, so I’m thrilled to be starting where I wanted to be!
realityrounds said
Awesome! You must let me know how it is going.