What Comes Around Goes Around

I sat in the same familiar seat in Louise’s office and waited as she shuffled some papers around on her desk. Although she was not on the phone, I had a déjà vu feeling. I tried to replicate the feeling of triumph that I had felt the previous day but it didn’t come. Finally, Louise looked up and acknowledged my presence.

“Hope,” she said as if surprised even though she was the one who asked me to her office.

“Yes Louise,” I replied.

“I got another visit from Dr. Evangelist. He was very angry about the amount of phone calls that he got from you last night and thought you may need further education on important information to relay to a doctor and when it is appropriate to call and not to call.”

“Important information to relay?” I questioned my eyes narrowing.

“Yes, he said you had to call several times for admission orders. Perhaps before you call a physician you should make sure you have all the information in front of you. When I was a staff nurse I actually developed a reminder sheet for myself and would fill it out prior to calling the physician,” Louise said.

“I don’t need a reminder sheet. The reason…”

“Now Hope. You have to be open to criticism and suggestions and less defensive if you want to improve your performance,” Louise interrupted.

“I understand that but I had to call Dr. Evangelist again because,”

“Yes that brings me to his second complaint. He said that you called him numerous times to report the patient was in a normal rhythm. In all my years as a manager I have to say that this is the first I’ve heard of this one,” she chuckled.

“I didn’t just call to report normal sinus rhythm,” I explained. “I called to report the patient had converted from A-Fib to normal sinus rhythm. I don’t really understand what the problem is. I work on telemetry and isn’t that my job, to report a change in rhythm,” I replied, hoping her own words would sound familiar to her.

“Well Hope. The drip that you started the patient on was meant to do just that. Do you know what the properties of the medication you started the patient on were?” Louise asked.

I knew this conversation was going to go south before I came in but I sat in awe for a moment, in disbelief. My response came out slowly, “Yes, Louise I know the medicinal properties of Cardizem.” I doubted she even knew what I hung let alone the properties.

I looked over to Louise as she started to fumble with some papers. “Hope, here are some educational sources that may be helpful to you. One is on Atrial Fibrillation and the other one is on the medications used to treat it,” she handed them over to me.

I took them from her and accepted defeat knowing that trying to explain my story was not going to get me anywhere. It was obvious that, just like the last time I was in her office, the doctor’s word was gold. Her sole mission was to kiss the doctors’ ass and make sure they were happy. Being supportive to the nurses was not part of the agenda.

“Now Hope. This is the second time that I have had to talk to you about Dr. Evangelist. This time, I’m afraid that I’m going to have to put this in your file and begin the first process of discipline,” she handed me some formal paperwork that I glanced over as she proceeded. “I expect this grievance between you and Dr. Evangelist will improve. The first step of this process is a verbal reprimand. If your behavior does not improve the next step would be a written reprimand. I hope that the information that I gave you will help educate you further on irregular rhythms and I do not want to see Dr. Evangelist in my office again. Do you understand?” she asked.

My anger came on subtly but slowly my blood began to boil. I held back the tears and refrained from jumping over the desk and clocking her. “Yes I understand,” I replied.

“Good. Now read over the material and if you need anything further I have an open door policy. You can come in and see me anytime,” she said pushing her glasses up from the tip of her nose.

“Thank you Louise,” I said as I got up and left.

Mercedes and BMWs passed by me as I walked through the physicians’ parking lot to get to my car. I was stewing over being in discipline when I saw the license plate EVNGLST on a green Jaguar. Before I knew what I was doing I pretended to trip just in case someone were to see me. My belongings scattered about me I dug into my pocket for a pen and jammed it into the tire valve. The hissing sound blew into my ear and it whispered, “calm down Hope. Everything will be all right. You don’t have to be angry anymore. What comes around goes around.” Slowly the air released from the tire and I felt my body relax. I gathered my stuff and as if the air transferred from that tire to me I floated to my car like a balloon filled with helium. I didn’t look back at the green Jaguar, sandwiched between a red Porsche and black Mercedes that leaned slightly toward the Porsche from a flat front tire.