This day occurred two or three years ago.
I walked in at 7:30 AM to the inpatient psychiatric unit. I found out quickly I was the only provider for twenty-six patients. We were already short one, then one call out and one psychiatrist working in the interventional suite. I had a team of three residents and two medical students, and myself, so we all just buckled down and started seeing patients.
It was kind of wild in general on the unit that day. We had a run of manic/psychotic patients who were loud, up generally all day and night, refusing medication, and one out of all of them who was particularly rude and verbally aggressive in their unmedicated state.
The other part of the culture on that unit was there was a very anti-nurse practitioner view by patients. They always wanted to see the doctor. But that day they didn’t have a choice because there were no Attending physicians to be had. It was nice always having a resident with me because I could at least say there was a doctor with me, but I ultimately was the one making decisions. So, there were a lot of irrational unmedicated patients. Some were angry about being involuntarily hospitalized and they really had no time for me because they wanted to see the Doctor.
I was in the middle of a particularly trying interview with a patient who was becoming verbally threatening around not being discharged when I saw a nurse run out of a patient room. He looked frazzled. On impulse I got up and went out of the interview room mid-sentence and stopped the nurse who told me a patient was seizing.
I was now in charge of a medical emergency. We called for transport to the emergency department. I started an IV and we gave Lorazepam (an anti-seizure medication). The patient was large, and it was hard, and we were doing this all in a psychiatric room which is not at all equipped or set up for medical emergencies. I was literally holding the oxygen mask on the patient after just pushing in the IV Lorazepam when some one tapped on my shoulder. “What?” I asked with somewhat of an attitude, as I was clearly busy.
“Um, you need to come out to the front.” I heard the voice of a tech.
“Kinda busy here,” I replied irritated.
“Um, the Secret Service is here.”
I sort of stopped and turned my head.
“You’ve got to be fucking kidding me?” I said. But I knew they weren’t. Because at that point I worked there for a few years, and we had been visited by federal marshals, sheriff’s, and the FBI, so really all that was left was the Secret Service. Psychiatry is nuts.
The ambulance stretcher rolled in. Thank God for paramedics. I gladly gave over my patient and walked out the door to go talk to the goddamn Secret Service.
My day didn’t get better from there.
After all of that we still had to write twenty-six notes. We discharged four patients, and admitted four patients. We reviewed labwork, EKG’s, medication doses, changes, etc. etc. etc.
We had to do all the normal shit healthcare providers do on top of rescue a seizing patient and deal with the Secret Service while working with one provider on a unit where there was supposed to be four. We did all this while one of the patients yelled racial and religious slurs at all of us. All day.
It was a Friday.
I vividly remember this day. I remember thinking I don’t get paid enough to keep my brain sharp enough to deal with this shit. I remember thinking NFL players get paid way too much to get their brains turned to shit. I remember feeling thankful I had my colleagues: the nursing staff, the residents, the social workers, everyone was a team. That’s the benefit to working in a hospital setting. I remember feeling burnt out; physically and emotionally exhausted, and also gross because the seizing patient puked and I felt like I had flecks of vomit on me all day. I hope to God I didn’t. But it was a possibility.
I remember mostly though that whole day no one cared or thought to ask about my sexuality. It didn’t matter that I am a lesbian when I threw the IV into that patient’s arm and pushed the anti-seizure medication. The families I met with to review discharge plans for their family members, the patients who screamed and swore at me for not discharging them, and all the staff. No one could have given two shits that I was married to a woman. Because I was competent and I got the job done. I’d like to think I got it done well.
The religious right says the homosexual agenda is to “normalize” homosexuality. Well duh. Because my identity as a lesbian has nothing to do with the ability to perform my job as a nurse practitioner. It has nothing to do with my ability to be a wife or mother or daughter. Being homosexual is normal. For me. I am a normal person who happens to be gay. If that was your relative seizing, and I was the one running the response, would it really matter to you if I am a lesbian or not?
Would you want me to step back and let a straight person who might have less skills as a nurse step in because they are straight? Gotta be honest even if that’s what you want I wouldn’t let it happen. Because my duty as a nurse and a human being would not allow me to let someone potentially die because of some one else’s ignorance. I’d tell you to shut the hell up and get out of my way most likely.
My ability to function and to be a contributing member of society has nothing to do with my sexuality. And this debate over whether people have the right to refuse services to others based on sexual orientation or gender identity infuriates me.
Illness eventually touches everyone. Illness does not discriminate. Remember that every single person will at some point be in a hospital. Think long and hard about whether you want to give your nurse, doctor, tech, surgeon, anesthesiologist, the right to discriminate.