Sometimes the Truth is Hard to Swallow

Signs of a Toxic Work Environment —

You flinch when someone says your name. You only see management when something goes wrong. It’s all about blame versus problem-solving. You have diarrhea before your shift. You have diarrhea  after your shift. You fantasize about ways you can get hurt and file a Worker’s Comp claim so you don’t have to go […]

via Signs of a Toxic Work Environment —

The Descent

By P. Pharm RN

There once was a nurse trapped up to her ankles in quicksand.  Her
manager asked, “How did you get yourself into this predicament?”  The
nurse replied, “I don’t know.  I was helping a patient and before I
knew it, I was caught in this sand.”  The manager rolled her eyes and
said, “Once you’ve figured out how to free yourself, bed 9 needs pain
medicine.” And she walked away.

The nurse looked down at her stuck ankles and started to panic.  She
worried that she might be stuck forever.  Slowly, the sand crept up
her calves.  Hours had past and her manager appeared behind her.  “Why
are you still standing here?” She sharply and callously asked.  The
nurse looked down at her submerged calves and wept.  “I am stuck and I
haven’t been able to free myself.  Can you please help me get out of
this hole?”  The manager looked at her watch and said, “I am late for
a meeting.  Why don’t you call Employee Assistance?  Maybe they can
help you.”  And she walked away.

Slowly the sand began to engulf her legs until her hips were embraced by the sand.
Her manager again made her rounds and saw the nurse
still trying to free herself.  “Did you call the Employee Assistance
hotline?”  The nurse looked down and shrugged.  “They put me
on hold twice.  Eventually the calls went straight to voicemail.  I
did leave a message explaining my troubles.  Can you help me?”  The
manager looked at the clock on the wall and exhaled.  “Have you asked
your co-workers to help you?  You really need to learn how to delegate
tasks to others.” And she walked off.

The nurse spent hours asking other staff to help her but they were all too
busy.  By now, the sand reached her chest and it was becoming hard to
breathe.  The manager asked her why she was still stuck in this hole.
The nurse almost breathless replied, “my feet were caught and you
blamed me.  I sunk further and you walked away.  My legs were fully
submerged as I wept and you mocked me.  Now, I suffocate and you have
the audacity to ask why I still linger in this pit of despair.  “Why
do you discard me so?”  The manager looked down at the nurse and
replied, “Because those who sink cannot be saved.”

The manager walked away as the nurse descended into darkness.

Signs of a Toxic Work Environment

You flinch when someone says your name.

You only see management when something goes wrong.

It’s all about blame versus problem-solving.

You have diarrhea before your shift.

You have diarrhea after your shift.

You fantasize about ways you can get hurt and file a Worker’s Comp claim so you don’t have to go back.

You wonder how you can possibly get through one more shift much less another two or three decades until retirement.

You contemplate increasing your life insurance so your family will have a better nest egg once you’re gone.

You count your sick days like addicts count pills.

You take pills so you can get through your workday.

You think about starting a home lobotomy business and know your coworkers will buy into your MLM plan.

You fantasize about being homeless instead of worrying about being homeless.

You think moving to a Third World country would be a vacation.

You have two or more stress related illnesses.

The idea of talking to people on your days off puts you into a panic.

They tell you you’ll never get another job and you believe them.

You wonder if prison has a better work life balance.

I Cut Myself.


By P. Pharm, RN

It didn’t take much to set me off into that rapid, swirling decline of drowning despair.  I had been heading in that direction for years.  The nosedive began when I watched my best friend among others being bullied, shamed, and pushed to the breaking point by management.  The hospital’s administration had molded its culture into a self-serving business model that took a no-prisoners approach to leading its employees.

The nursing staff existed for the sole purpose of providing optimal patient satisfaction with the final product of maximum reimbursement.  The cost being too high for the emotional, spiritual, and physical livelihood of its employees.  There was no 99 percent one could give.  You either operated at 110 percent or a 0 percent failure rate.  I believed that I was supposed to be a perfect nurse.  Any mistakes meant total failure and shame which sent me into a depression.  This was reinforced by my superiors through threats of written warnings which took away the only annual bonus offered.  If a mistake was made, everyone knew about it and it was placed in our permanent record.  That mistake followed you wherever you went.

I watched a nurse make a medication error which resulted in no harm to the patient.  She took the policy enforced path of self-reporting the error to the physician and her superiors.  She was counselled, written up, bonus taken away, threatened with possible termination, and shamed.

I witnessed another nurse openly voice her burnout to management which resulted in multiple future write-ups and a strong suggestion that she find work elsewhere.  She slowly emotionally deteriorated under the pressure.  The manipulative tactics used were geniusly executed.  I was horrified over how sly and calloused leaders in the medical profession actually are, as they dress up in the costume of healthcare servitude.

A fellow nurse admitted to me she was on 8 prescription medications just to function. Another one said she has never been on as many antidepressants in her life as the present. Another was diagnosed with Colitis.  Another Crohn’s disease.  Fibromyalgia.  Cancer. Obesity.  Depression.  Drug addiction.  This list goes on.  We were all battling something. Yet, it was barely talked about.

The quantity and frequency of my panic attacks grew and grew.  I couldn’t control the suffocating feeling that overwhelmed me during my shifts.  The patients may have been stable but I constantly convinced myself they were about to code or I was on the edge of making some catastrophic mistake.  This feeling took over and there was no way to conquer it.  And this monster kept growing bigger and its behavior more unpredictable and out of control.

I heard the term “self-care” thrown around by administrators.  Honestly, I tried “self-care” but the true self-care came when I chose to leave this toxic establishment.  Massages and meditation can only go so far and probably only temporarily band aid a small fraction of the true problem.

While others outwardly voiced their displeasure, I was imploding on the inside.  My health declined and I found myself withdrawing from people and life.  I slept more with no change in the overwhelming fatigue I couldn’t beat.  I fought more with my husband and I wondered if we would make it.  I couldn’t stand being around my children yet I missed them terribly.  I was dying in every way.  I contemplated not existing anymore.  I couldn’t stand my job and couldn’t stand the person I saw in the mirror.

One day, I just started cutting.  I watched the blood run down the shower drain.  I was shocked that it didn’t hurt.  It actually felt good.  Bringing the evidence of my internal pain to the outside was a release.  Until, I felt the stupidity of it all.  Why was I hurting myself over a job?  Why was I allowing myself to be a victim?  Why was I allowing in all this pain and misery?  And, possible infection?  What the heck was I thinking?

I called in sick for my next few shifts.  I saw a counselor and a psychiatrist.  Amazingly enough, they said they had many nurse-patients with the same symptoms as myself.  My symptoms were finally validated.  I was diagnosed with anxiety and depression.  I was placed on a leave of absence and I gave myself permission to emotionally and physically heal.  It didn’t take long to feel a renewing of my soul and body.

Most of this article is about the mentioned evil healthcare machine and I paint myself as its victim.  But, I place much blame on myself for not taking a risk sooner and leaving.  I let fear dictate my future.  I was scared every job was the same.  I feared I couldn’t measure up to anyone’s expectation of who I was or what I should be capable of.  I put too much emphasis on a paycheck instead of my own sanity and well-being.  I was stuck in a self-dug trench full of lies I had believed for way too long.  No longer.

It took me less than a week to find a new job.  One that wasn’t oppressive or abusive.  They really do exist.  Nursing with respect and dignity for the professional is not some made up fairy tale told by nursing schools for recruitment purposes.  So, know that if you feel your situation is similar to my story,  I want you to know you are not alone.  Many have been there and recovery is out there.

Please don’t let a job, a person, or a situation destroy you.  Your feelings are real and deserve to be validated.

Self Care


By B.P. Betty, RN

Self-care is an idea that sells a lot of books. It is the idea behind hundreds of workshops and is thrown around corporate medicine as a way to tell staff that if they are feeling sucked dry  and burned out, then it’s their own fault. It’s just one more thing they need to do to be a better nurse, because they aren’t good enough as they are.

Self-care is a difficult concept for people who are willing to empty themselves every day for others. Self-care is an afterthought for those of us who care more about the community than our individual well being. Self-care is just another tagline to make us feel inferior about our limits and capacity to give without breaking.

The tragedy is, nurses and other front line caregivers don’t tell other people how we feel because it is perceived as being weak. We are hopeful that they will notice and assess our pain the way we do for everyone else, but it never comes.

Heal the healer.
Physician heal thy self.
How many times have we heard this? How many times has it actually been encouraged in any of the institutions in which we work. How many times are we asked to work double shifts or overtime or be on call? How many times does “heal thy self” really matter when the unit is understaffed? How many facilities have dismal time off allotments? How many of us have been written up for taking too much time so we can can care for our children or spouses yet never take a day for ourselves without guilt.

Healthcare culture has nothing to do with healthcare. It is all algorithms and surveys and percentages and profit margin’s. It’s making sure our  i’s are dotted and out  t’s are crossed so state surveyors or insurance companies don’t come back and audit our institutions. Nurses are told they are good nurses if their charting is perfect. Few nurses are told they are good nurses when they spend their time in a patient’s room holding a hand or holding a patients hair back while they are vomiting, or spent crying with a patient who knows he is dying.

We are supposed to be patient advocates, not self advocates. However even that advocation for patient “care” is only important when it comes to length of stay, or planning discharges before the admission paperwork is even completed, or the risk for readmissions is measured more for reimbursement than the care of humanity.

Self-care only matters when it affects the bottom line. We put ourselves in harms way every day for strangers while our families suffer and our own health suffers. We keep waiting for someone to care for us. We keep waiting for someone  to look at us with the same type of assessment and empathy we do when we look at our patients. We keep waiting for someone to say, “you look tired”. “When was the last time you had a day off?” “How are your kids?” “You’ve been working a lot, lately. How are  you holding up?”

We keep waiting for someone to assess us, to hold our hands and acknowledge our suffering, yet it never comes. So, we continue to suffer in silence. We continue to believe the lies that unless we are working extra shifts, unless we are charting in triplicate and it’s perfect, unless we are doing pain assessments every 15 minutes, pleasantly agree to an admission while still recovering from a code that’s gone badly, we are bad nurses. We cannot be human. It makes us weak.

There can be no weakness in healthcare. We must be strong for the weak. Without strength there can be no healing for others. So we continue to push ourselves until we crack and break. We continue to down our own handful of pills before we go to our shift. We continue to smoke and drink and isolate. We stop trusting our instincts because we are told that they are wrong.

Our biggest mistake is believing them. We are advocates for so many.

We advocate for the homeless.
We advocate for the addicted.
We advocate for the poor.
We advocate for the uneducated.
Who advocates for us?

We are too tired and too broken to save ourselves. We are bleeding out. We are told to transfuse ourselves, start our own iv, hold pressure and keep moving. We are desperate for someone to save us. We are desperate for someone to acknowledge our pain. We are nurses, we are supposed to not need anything.

Instead of throwing us a life jacket or safety ring, they throw us more pills. They throw us more classes. They throw us bullshit taglines about self-care when we all know it’s a big fucking lie.

They don’t care if we are well. They only care that we are upright and breathing. They don’t care that we are abused daily. Our suffering is inconsequential. Go to a therapist. Go to your doctor.When all those things are supposed to happen on our  one day off between 3 back to back to back 12 hour shifts, who actually has the energy to go? It means we actually have to get out of bed.

When we  don’t even have the energy to  move, how can we be self advocates? Especially when we know the therapist is just going to tell us we need to take another pill or that we  need to take a day off. When that day is requested, we are chastised for not being a team player. We also know that, by taking a day off, our  coworkers are going to be short staffed. (Remember how they tell us we are replaceable? Well they sure as hell don’t replace us on a daily schedule, do they?!) We know at least one or two nurses  that have confessed to feeling the same way; the idea of leaving them stranded gives us enough energy to drag our  broken selves from our bed. We drink our coffee. We take our  pills. We stumble to work wiping the tears from our eyes, hoping the jagged sobs that come in waves on the  commute will get us through one more shift. We hope nobody notices our  swollen eyes but all the same, hope someone does.

We need a nurse, but can’t have one -we are nurses. We are suppose to be infallible and unflappable, so every last ounce of self-care we  could possibly have is funneled into a half a dozen patients who may, or may not,  be worse off than us.

Top Reasons Prostitution is better than Nursing


1.  You still have to  work nights, but at least you get to spend it on your back.

2.  No charting!

3.  You only have to keep them alive for 30 minutes- not 12 hours.

4.  Pillow therapy means something completely different.

5.  The only person to micromanage you is your pimp.

6.  You only have to service one person at a time

7.  Evidence-based practice?  They “finish.”

8.  The only thing better than wearing  scrubs to work, is wearing nothing to work.

9.  If someone  pees on you, you can charge extra.

10.  Groin management is welcomed and not feared.

11.  If you get hit as a prostitute, you can press charges.

12. Patient satisfaction? No surveys!! (See #7.)

13.  Frequent fliers mean you’re doing a good job, not a bad one.

14. Cash tips.

15. You actually get paid when someone tells you, “hey honey! Look at THIS.”

16. STDS are easier to clear up than C-Diff or MRSA.

Dear CEO,


I would have followed your lead anywhere. I followed you far enough into hell to know neither you, your “vision” nor your healthcare system are worth my sanity, my health, or my life.  Here are some quotes from your “leaders.”

You’re lucky you’re here.
Don’t you have a mortgage and kids to worry about?
You’ll never find another job.
No one will pay you what we pay you.
Our standards might be too much for you.
This is they way things are.
Your idea of being a high achiever is flawed.
No one else is complaining.
Patient satisfaction is everything.
Maybe you shouldn’t be a nurse.
It’s you.
—All lies.

It took me years to stop believing them. It will take another lifetime to heal the scars.

More things managers say to beat the life force from their staff:
We don’t give references to jobs outside of our own system.
You are replaceable.

Hearing from people who still work at the abusive corporate headquarters of the Deathstar Healthcare, Inc. makes me realize how lucky I am to have gotten out alive, how terrified people are who are still there, how insidiously evil corporate medicine has become.  My personal and spiritual crisis peaked when I walked.  My healing began when I took a risk and left everything I ever knew and experienced as a nurse. 21 years of my life in a system that says “everyone is replaceable.” May that same system also be replaced as the people who helped build it walk out, away from the raze and burn mentality of robot mafia medicine.

If you think you matter as a hospital “professional” of any kind, you’re one patient survey score, one wrong opinion voiced, one missed chart check away from finding out you don’t. People are dying in and because of hospitals all the time. I guarantee you these days, most aren’t patients.

When I am told I need to do busy work instead of holding hands and hearing stories from my patients who have no one else to hear them just  so “executive leadership” can prove the numbers to get their bonuses, then I am a basically a prostitute and my director is a my pimp. There is no health or care in healthcare.  There is no healing. There are only profit margins and bean counters and “profit before patients” mentality.

Those who point this out, the whistleblowers who refuse to lose their souls because healing is their calling, they are shamed into submission. PTSD is real in the hospital. And it’s not just the patients that suffer from it.

When I started nursing, I thought I was walking into a temple to find Jesus. Turns out I ended up on an evangelical  TV set with Jimmy Swaggart’s hand up my ass.  I simultaneously lost my faith and my profession over the past few years. At least I got out before I lost my soul.

I spent 21 years of my life thinking I was married for life to my employer. Much to my horror, I realized over the past few years  I was never considered a “wife.” I was always just a whore.

Since leaving I am now:

Off 3 cardiac medications
Off 2 psychiatric medications needed for a medical diagnosis of PTSD secondary to caregiver fatigue secondary to a health system that no longer gives a shit about humanity on either side of the stethoscope.


Former Hospital X cult member and kool-aid drinker
Former patient
And now–
Advocate for abused and burned out providers and healers.

No longer corporate ID 128349

I have a NAME:

Bedpan Betty, RN



By B.P. Betty, RN

Leave Me
Leave Me
I beg you
Leave me
It is time for you to go
Past Time
You aren’t the first to leave me behind
The tears on my cheeks
Are hot with grief
For me
Not you
We have known this moment would come
We have talked without speaking
Your eyes piercing mine
For the Truth
You will
Leave me soon

For now each
Ragged breath
Belongs to me
I kiss your head
For the tenth time today
My tears glistening
On your scalp and
For this instant
You still belong to me
I whisper to you
You moan your response
I straighten your sheets
For the one hundredth time
I cry
Each time I am left behind
I never dreamed
I would be death’s midwife.

For all my patients whom I have loved – Godspeed.



Blog at

Up ↑