Fledgling Nurse, Part 3: Language

There is a different way of talking out on the floor.  Yes, there is a fair bit of jargon floating around, but that doesn't encapsulate the full flavor--no one I speak with on the floor sounds like a textbook to my ears, at least.  

My coworkers are also starting to realize that I 
come with catchphrases...

Brevity is not my strong point.  You may have noticed.  My brother told me once that I speak in essays, and I think about it from time to time, even in how I draft things I want to say and write.  It's not impossible for me to tap into brevity, but it does take a level of intentionality--the ideas tend to wind to a point at the end, coming together through various explorations of thought and verbiage.  This is more for deeper discussions and playing with hypotheticals, but there are still places that it crops up in "normal" conversation.  So I have my voice, which goes through various filters depending on the needs of the moment.  There is a dominant influence from my English major brain paired with a few successful NaNoWriMos.  In fact, the first scientific paper that I wrote and turned in for research--a completely different kind of writing--was veritably covered in red ink, slashing out my descriptive phrase, adverbial clauses, and all other facets designed to add flow.  The work was stripped to choppy sentences of only the essentials.  It was a jarring but important lesson:  the creativity came not in the wording but instead in the ideas behind the research.  I needed to consider words differently, and I'm finding that I might need to again.

As such, I have been paying attention to how people speak on the floor and I have identified three facets of communication between nurses, in no particular order:

1. Brief:  When giving report, my impulse is to frame it like a narrative, to describe the story.  Odds are the nurse receiving report would be very grateful if I spit out the specifics without the color commentary.  After all, they have four other nurses that they have to tackle to get report on four other people before than can get going on their day.  Their phone is also already going off because one of them needs to go the bathroom and the tech is helping another patient with the same already.  There are always additional irons in the fire, whether they're immediately visible or not.  We're even taught in nursing school to start with the point and then fill in the background, the whole design of the SBAR format in making a question.  When communicating with doctors, I try to tell myself that it needs to fit in an original tweet length.  Keep it simple.  Be direct.  Spit it out.  Add additional information when asked.  
2. Morbid:  Those in fields close to death tend to develop (or already have) an altered sense of humor.  It's a defense mechanism, to help release some of the pressure and otherwise to protect oneself.  We were having a conversation at the front desk one day about what happened to larger persons when they die, specifically how could someone be cremated if they didn't fit into the machine.  It was a bit uncouth from the outside, but it was fueled by genuine curiosity and something that needed levity in the midst of the stresses of the day.  As with many things, stories traded around are hilarious in retrospect but terrible in the moment, adding evidence to the axiom that tragedy + time = comedy.  As a hypothetical, discussing how a confused patient ripped out their IV or central line, in the moment there might be a chorus of "ohshitohshitohshit" and a few other choice words going through my head while deciding what to do next, but that certainly wouldn't be how I tell the story later in the day--it would become more of an epic on how my patient looked like an extra from a Halloween slasher movie.  The emotionally difficult pieces can't all be processed immediately--there are other patients that also need care that day--but there are tiny outlets to take a breath of air before diving in again.  That small gasp of air is the brightest moment in a bleak storm of terrible things.  So, no, it's not a joke for polite company to talk about blood or vomit or death or dismemberment, but the laughter is needed.  And one finds it where they have to.  
3. Constantly interrupted:  Maybe the group is talking about what happened over their vacation, but then an alarm goes off.  Or someone might be venting about something when the tech walks up with some important patient information.  Or maybe one nurse is seeking advice from another and both of their phones go off at the same time, they resume conversation and another phone goes off again.  The point is there are many conversations that start but the majority are interrupted and never resumed.  Some days, your phone truly does not stop ringing.  Pieces that need an answer--sounding board kinds of conversations--are easy to resume or start with a new body, yet there are many conversations where we're supporting our peers as people or talking about other life things that are important to us that never have an opportunity to continue.  In the beginning, I tried to wait for parts of the conversation to naturally ebb before interjecting important information.  However, then I found there never was a chance unless I just throw the information out there.  As a result, I've seen two major effects in how I approach staff conversations:  I feel an increased pressure to speak in conversation the less urgent it is, lest the opportunity fizzle out immediately, and I interrupt a hell of a lot more if there's any kind of actual urgency.  

So, yes, there is a veritable alphabet soup of acronyms, jargon, and all else floating around, but there's also a style.  There are moments to breathe and moments to laugh and moments to vent and moments to see your peers as people.  There are also spaces where we're just surviving at the moment, "eggshell fine," if you will.  I'm adjusting my scripts as I go, finding what pieces I'm going to keep and refine.  

Definitely going to work on the brevity thing.  Eventually.