The magical mystery land of community health

I don't make this stuff up!…but I do change identifying information.

Lesbonurse visits her people May 31, 2008

Filed under: Uncategorized — lesbonurse @ 2:40 pm

As I write this, I’m sitting in a hotel room in Philadelphia, preparing to wrap up my attendance at the 2008 Trans-health Conference. It was awesome to be here–and even awesomer that I got to pay for it with my continuing education money. Woohoo, professional career!

But seriously, this was a conference that I have been waiting months to go to. I got to be surrounded by my trans and queer brethren, take 2 days off of work–thank god!–and get educated about the shit that no one is teaching in school. (Also, as an added benefit I got to scope out all of the hot conference attendees)

As I sat in the Provider Day workshops, I was overcome by an unexpected wave of loneliness. I listened to other people talk about their work with the LGBTQ community and their trans health programs, and I realized how totally isolated I am at my job. Yes, I do have an awesome collaborating physician to back me up on the necessity of providing LGBTQ health care in our community. But in my day-to-day work life, I am so far removed from the queer community. Just as an example, here is a conversation that I had with one of our clinic nurses shortly before I left (her father-in-law is female-to-male and transitioned 2 years ago):

Me, to nurse: “Hey, tell your husband that I’m going to a national Trans Health Conference next week and I can bring him back some information for his parent if he wants it.”

Nurse: “I’ll tell him. I’m sure he won’t want anything.”

Me: “Ok, but it’s going to be good. Lots of good info.” (admittedly, at this point I was just goading her, but I couldn’t help myself)

Nurse: “I’ll tell her [the FTM parent]”

Me: “You mean HIM”

Nurse: “Whatever. I don’t have a problem with it. I just won’t call her him. And I won’t use her new name.”

Me: “So you have a problem with it.”

Nurse: “No, I don’t.”

Me: “So call him him, then.”

Nurse, shrugging and preparing to walk away: “whatever”

Me, under my breath: “fucking kill me”

So yeah, it was great to come here. I talked to my collaborating physician before I left about doing a lunchtime presentation for the residents on the topic of trans health. We’ll have to see how it goes.

 

The totally professional comment May 25, 2008

Filed under: Uncategorized — lesbonurse @ 4:44 pm
  • As some of you may know, I’m the go-to-gal for paps and pelvics in my clinic. So I wasn’t surprised when one of the first-year residents flagged me down in the hall and asked me to come into an exam room with him to make sure he had located a patient’s cervix correctly. What did surprise me was that when I opened the door, this poor patient still had the speculum cranked open inside her vagina! She seemed remarkably un-angered by the fact that her doctor had just left her alone in a room with a speculum in place for several minutes (although perhaps she felt more empowered to be mad once her clothes were back on). After helping the doctor finish the exam, I stopped him outside of the room for a little ‘feedback.’ Professional comment: “I just want to let you know, from a woman’s perspective it is VERY uncomfortable to be left with a speculum in like that. So next time, take it out if you need to leave the room, ok?” Unprofessional comment: “I know you’re a moron, but come on! What on god’s earth would make you think it’s ok to leave someone like that?!? You wouldn’t leave a man with an anoscope in place, would you?”
 

Lesbonurse, spiritual advisor May 19, 2008

Filed under: Uncategorized — lesbonurse @ 1:14 am

Those of you who know me well may recall that I am a die-hard agnostic. While I am unsure about the mysterious forces that create and destroy the universe, I am a firm believer in the randomness of life. Therefore, my “spiritual inner life” does not incorporate prayer to any specific deity (nor do I have a strong belief in any specific deity).

On Friday I tried my most awkward intervention yet…encouraging spiritual practice. I had just called a patient to tell him that his 2nd Hepatitis C test had come back positive, cementing the fact that he really does have Hep C. When I told him that his test was positive again, he immediately began crying hysterically and saying, “Doctor, I’m going to die, aren’t I? Ohhhhhhh nooooooooo, I’m gonna die.”  I tried several conversational tactics, including reinforcing the education I had done at our last visit and reviewing the fact that all of his liver tests were totally normal (thus indicating that he will not be dying anytime soon). When that failed, I moved on to firmly saying “No, you are not going to die. Take a deep breath. Your liver is fine. I’m serious–you’re in good health. You’re not dying!” After we had been on the phone for 20 minutes, I knew I had to get out bigger guns. He had mentioned that he figured God was punishing him for his history of sexual promiscuity. I decided to take the religious route. I asked him if he attended church. He said that he does have a “church friend.” Attempting to sound as natural as if I provide spiritual counsel on a daily basis, I casually asked, “Well, do you…um…think you could pray on it with your church friend? Cause…you know…many people feel better when they talk to God about stuff.” He admitted that he might be able to talk to his friend about it, and that he thought he might pray on it a little. Whew–just like in the nursing textbooks! Check out that patient-centered care!

 

Q & A May 15, 2008

Filed under: Uncategorized — lesbonurse @ 12:51 am
  • How did you manage to artfully, yet professionally, document a friction burn on a man’s penis? I described it as “a traumatic desqaumating injury.” (I think I invented the word ‘desquamating’)
  • What disturbing incident involving bodily fluids happened to you today? A woman confessed that she has been having fecal leakage during sex for the past 20 years, but she was too embarrassed to tell her PCP.
  • What were you thinking about as you listened to a bradycardic elderly woman’s heartbeat? I was thinking of an animal hibernating in a den…how the heart of a hibernating animal will slow down for the winter. I felt sort of peaceful and sleepy, listening to her heart beating at 39 bpm.
  • How do you know that you have PMS? Because I just got choked up watching an episode of ‘Scrubs’, for god’s sake.
 

Monday Haiku May 13, 2008

Filed under: Uncategorized — lesbonurse @ 1:22 am

Here for test results

No, you don’t have HIV

But you have Hep C

Distended stomach:

Bowel obstruction…or case

of constipation?

Special multi-part haiku:

walked out of rehab–

DVT, venous ulcer.

New patient visit.

Now, appointment with

inexperienced NP.

Too many problems!!

I have to admit,

You are way outside my scope

of NP practice

 

A little confession May 6, 2008

Filed under: Uncategorized — lesbonurse @ 2:27 am
  • Sometimes, I wish that I would have a manic episode so I could finally do all the things around the house that I keep putting off
  • Ditto to the above, except that sometimes I wish I could be hyperthyroid–just for a few days–to do all that work
  • Sometimes I wish that someone would prescribe me flexeril. My back really hurts and now I’m getting sciatic pain!
  • I wish that the people who live in “tornado alley” in the midwest would finally wonder why a natural disaster that happens to the west coast is God’s wrath, but a natural disaster that happens to them is proof of God’s blessings (even though people died!)
  • And I must confess…I do think that the gays have better fashion