The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital (44 page)

—a Virginia women’s health nurse

“It’s incredibly fulfilling. As a nurse, you have the opportunity to provide hope and comfort to people on what is often one of the worst days of their lives. I feel whole when I am caring for others, teaching them to care for themselves, and helping them heal.”

—a Washington, DC, cardiothoracic surgery nurse

At six feet two inches, with 230 pounds of muscle and a 32-inch waist, WWE wrestler Dean Visk was enjoying a successful second career when he decided to leave professional wrestling because he missed nursing so dearly. “I thought to myself, ‘I’m a healthcare professional.’ The WWE is wonderful, but I felt like nursing was my calling,” he said.

Visk originally got into nursing because, as an amateur bodybuilder, he was interested in the prerequisite anatomy, chemistry, and biology classes. He was a full-time behavioral health nurse for five years before moving to Cincinnati to work part-time as a nurse while training for the WWE. He trained for four more years before the WWE offered him a contract. The other wrestlers didn’t mock him for working in a predominantly female field; instead, he said, they were impressed that he had such a stable career to fall back on.

Now Visk is an outpatient facility nursing director who continues to wrestle on the side for charity functions (and tells patients who recognize him, “I don’t fight anymore; I heal”). “I’ve had nothing but positive experiences in nursing,” he said. “If it’s a sisterhood, then I’m right there wearing a dress with all the other nurses. I’ve always been taken into the sisterhood without any issues.”

Out of 3.5 million nurses in the United States, approximately 330,000 are male. The highest percentage is concentrated in anesthesia: 41 percent of CRNAs are male, while 9.6 percent of registered nurses are male.

Because murses are so dramatically in the minority, some of them have had to deal with lingering public stereotypes that they are gay or effeminate, which both devalues gay nurses and contradicts an
American Journal of Men’s Health
study finding that male nurses “hold a high degree of masculinity.”

“You know what’s not fun in your early twenties? Being well-dressed, walking up to a girl at a bar, sparking a conversation, and then telling her you’re a nurse,” said a Virginia murse who has contended with these stereotypes. “I had to work backward to prove my heterosexuality. Now that I’m older, in a long-term relationship with a woman, and generally more confident, I don’t really care what people think. But those first few post-graduation years were rough.”

An Oregon critical care nurse said that his favorite jibe about his job is “So, you’re a male nurse, huh?” He likes to reply, “Yep, I tried to be a female nurse, but couldn’t afford the operation.” (He added, “I am not effeminate. I am a dude.”)

Comments about being gay, feminine, or “not man enough” helped push one nurse to join the U.S. Army, which deployed him to Afghanistan with an active combat unit, at his request. The guys in his unit good-naturedly referred to his medical supply bag as “the murse’s murse,” for the male nurse’s man-purse. “I got to apply and test my skill-set and medical knowledge, at times in the most adverse of conditions, producing some of the most powerful memories I will ever experience,” he said. “On a few occasions, I was the first person on the scene for people who were critically wounded in battle. The opportunity to create my own valuable experiences is something that nursing offers that most other career fields don’t. Nursing puts you in the driver’s seat.”

Most murses said that these stereotypes don’t bother them, and that their sexuality, gay or straight, is nobody’s business but theirs. What bothers them is when (typically older) patients assume that because they are men, they must be aspiring doctors. A Canadian ICU murse said that while he had originally planned to be a surgeon, he changed his mind during the month he spent at his father’s hospital bedside before he passed away. “I realized, after seeing the effect that the nurses had on me and my family, that I could have a much bigger impact on patients by being at the bedside all the time, instead of simply writing out orders and operating on someone, but never really being there for them,” the murse said. “I get offended when patients don’t understand why I wouldn’t want to be a doctor, or they keep asking about my ‘real aspirations’ in life. When that happens, I have to explain that my goal is to be a nurse, I love what I do, and I get to do more as a nurse.”

A Maryland medical floor murse had been on the job only a few months when, even after he had clearly introduced himself as a nurse, the patient and patient’s family continued to refer to him as “doctor” and the female physician as “the nurse.” A Delaware murse explained why this is insulting not only to the doctor but also to the nurse. “It insults my profession when people think that if I say something smart, I must be a physician,” the nurse said. “When I worked in the ER, patients would say, ‘You’re so good! Don’t you wish you were a doctor?’ No. I’m a nurse. It’s like telling a chef he’s so good, why doesn’t he become an IT programmer. It is absolutely infuriating. And female nurses never have to deal with it.” Dean Visk, who is finishing his master of science in nursing degree and plans to get a PhD, said that even when he becomes a Doctor of Nursing Practice, “I’ll still identify myself as a nurse. I’m very, very proud to be a nurse.”

On a personal level, murses’ experiences as the minority gender can vary, depending on the unit: While many, like Visk, feel welcomed, others deal with occasional teasing from coworkers. Professional challenges can include “always having to take the infected patient because you’re the only one who can’t get pregnant,” a New York NP said. The Oregon nurse echoed a common murse observation that they are disproportionately assigned to the most difficult patients and often get called in to do the heavy lifting.

But they get paid more to do it. According to the U.S. Census Bureau, male nurses ride the “glass escalator”; although they are in the minority, they receive higher wages and faster promotions than women in the same jobs. The wage gap is smaller in nursing than in other professions, however. Compared with men, women earn ninety-one cents to the dollar in nursing occupations, versus seventy-seven cents to the dollar on average across other fields.

Some men become defensive about being in a field with mostly women, but the majority of the murses interviewed for this book didn’t consider the disparity to be a problem. “Yes, I’m in a job where I am surrounded by women. But guys, come on, I’m in a job where I’m surrounded by women!” said the Army nurse, who is now stationed at a base in Europe and engaged to a female physician. The murse’s female coworkers and the “sixty-five sisters” in his nursing school class provided him with “access to some pretty big answer keys,” he said. “I dress better than most of my male friends, I understand what I did or said to make a woman upset or happy, and I have an endless supply of opinions on gifts and date ideas.”

The murse, however, cautioned other potential male nurses, “As a general rule, you aren’t in the nursing field to get laid.” Instead, “If you’re the caregiving type of guy, you should join us because of the wide range of nursing opportunities. You could work in a hospital or nursing home, dabble in management and administration, you can travel, or you can stay put,” he said. “Don’t let the female-dominated work area intimidate you. Want to know what brings a smile to everyone in the ER? Seeing that big burly wall of muscle and testosterone who’s good with kids. There’s nothing like a nurse’s feeling of satisfaction at the end of the day.”

One night, the charge nurse found Sam in Zone 1 to give her a five-minute heads-up that a trauma was on the way: a pedestrian who was struck by a car and thrown several feet. Five minutes was a decent amount of time for nurses to prepare for a patient; typically medics didn’t call Citycenter until they were practically on the back ramp. Sam arrived at the trauma bay at the same time as CeeCee. Before Sam could open her mouth, CeeCee announced, “I’ll be bedside and you can document.” CeeCee thought bedside nurses got all of the glory, but Sam didn’t believe that one nurse was less important than another.

Sam shrugged, uncomfortable about working with CeeCee. At least CeeCee had just returned from a three-week vacation and seemed relaxed and ready to work. Sam crossed her fingers for a drama-free night.

When the already intubated patient came in, a physician conducted an assessment while various doctors hooked the patient up to the vent and inserted a chest tube. Sam recorded all of these procedures while CeeCee took the patient’s blood pressure.

The moment the patient began to wake up and fight the ventilator, Sam pulled drugs from the Pyxis and handed them to CeeCee. CeeCee continued to monitor blood pressure and assist the doctors as Sam recorded. When the patient stabilized enough to move him to the CT room, Sam helped CeeCee hang units of blood before, during, and after the scan. (“The scaredy-cat doctors were all behind the glass watching us get irradiated,” Sam said.) Sam was surprised to notice that she and CeeCee worked well together, managing the flow of various doctors’ orders and dispensing medications.

Once CeeCee took the patient to the ICU, Sam began her hour-long stint at the computer to document the series of procedures coherently. When CeeCee returned from the ICU, she sat down for a few minutes to help. Sam hated to admit it, but CeeCee was a good nurse under pressure. She finished documenting with a newfound respect for CeeCee.

Sam had come a long way in only a year. She had realized that “everyone is going to come to the table with different opinions and personalities, but the goal is to take care of patients, so everyone getting along is important. As I learned, it’s hard to be on your best behavior for twelve hours when your coworkers are pissing you off. But you work extremely closely with them. I’ve worked with people who’ve touched my butt more than guys I’ve dated (it’s totally normal for people to take my trauma shears out of the butt pocket of my scrub pants). Patients come and go, but your colleagues can make or break your shift. So I can at least give everyone a chance.”

Sam’s next patient was an intubated man with carbon monoxide poisoning. She monitored his propofol, a powerful sedative that required just the right balance: enough to keep the patient sedated, but not so much as to lower his blood pressure excessively. Within a few minutes, the man started bucking the vent, agitated. His chest raised, his head strained against the stretcher, and his heart rate increased. Before the man could wake up, Sam increased the propofol. Three minutes later, the man’s blood pressure dropped. She lowered the propofol. Ten minutes later, the man became agitated again. Sam called in a tech to help her hold the man’s arms down so she could increase the propofol once more.

Sam paged the attending doctor. “The propofol isn’t really working,” she said. “I think we need something else to sedate him.”

The attending nodded. “Good call. How about a Versed drip?”

Sam nodded and prepared the drip.
He actually listened to what I said! He took me seriously!
she thought.

After a few hours of standing by the patient’s bedside and watching his monitor, Sam noticed that he was having longer and longer runs of bigeminy, a heart rhythm that, while not immediately threatening, could lead to more dangerous rhythms. She checked his labs, saw that his magnesium levels were slightly low, and found the attending. This doctor was a reasonable man who had worked at the hospital for decades.

“His mag is one point two,” Sam said. “I think we should give him magnesium.” Low levels of magnesium could cause irregular heart rhythms.

“Good call,” the attending said. “Why don’t we give him two grams of mag.”

Sam hung the bag of magnesium on the IV pump. She was pleased. For so many months at Citycenter, the charge nurses had assigned her to zones that didn’t see seriously sick patients, making Sam feel as if the staff didn’t think she knew what she was doing. “Now I have a sick patient and the doctors are listening to me,” she realized. “Maybe I kind of do know what I’m doing after all.”

Everything seemed to be falling into place. Sam and William were happy together as a couple, but they kept their relationship under wraps at work. She didn’t want to fuel any more rumors, especially when she was finally gaining respect as a nurse. Her professional reputation was becoming, in her words, “I’m a no-nonsense hard-ass. We’re going to do things the right way and efficiently and don’t give me any crap.” She liked that reputation because it minimized drama. “If everyone is clear that’s the way it’s going to go from the start, then staff are less likely to sit around and have social hour.”

Even she and Dr. Spiros had gradually thawed. The gossip about Sam had tapered off, probably because of CeeCee’s vacation. Sure, nurses made comments here and there about Sam’s supposed love life, but Sam could let those remarks slide.

A woman in her early thirties came in one night with stress-induced supraventricular tachycardia, a dangerous arrhythmia in which the heart raced at more than 180 beats per minute. To treat SVT, staff first tried getting the patient to bear down as if having a bowel movement. This was a technique aimed at activating the vagus nerve—called a vagal maneuver—to slow down the heart. If that didn’t work to bring down the arrhythmia, the next step was to administer adenosine, a drug that stopped the heart for a few seconds so that it would hopefully resume at a slower rate. In the ambulance on the way to Citycenter, the medics fortunately had been able to use adenosine to convert the patient’s heart rhythm back to normal.