When I first started in the ICU I used humor a lot with my patients. I began developing this skill when I worked at the video store and was able to size people up within a few seconds of meeting them. I could feel out who was and was not one of those with whom I could joke. So it comes as no surprise that I am slowly becoming famous for my line, "Is that bad."

The first time it just popped out. It was one of those first nights that I flew solo in the ICU and we had a code. When we had worked on the patient for over 40 minutes we were all looking at an asystolic rhythm on the monitor there was a pregnant pause. It was that pause that usually happens at a code when everyone is silently thinking that we just should call it, it's over, and then usually someone verbalizes that thought. Well, in this case, I took one look at that rhythm and blurted out, "Is that bad??"

In hindsight, it was very inappropriate for me to say something so horrible at that time. But what happened was that everyone laughed. It did something that I now realize is very important to keeping your sanity in nursing, it broke the tension that hovers over our head every moment we're dealing with the sick. And it is sick isn't it? That we make these jokes and laugh, but if we didn't we would all go crazy and this job would eat us alive.

So...now I have moved on to the ED. I hear from my old pals in the unit that when something really horrible happens that someone usually says my line in private to the other nurses and doctors. I feel like a celebrity.

Which is when I realized that this line has followed me to the ED. My co-workers are always approaching me with the line. "Cas, your lady in 8 has a K of 9.4...is that bad??" for example, or, "The police are bringing in a man who tried to kill his ex-wife and her dog at the Rite Aid...is that bad?"

It's a great line. So, if any of you out there are feeling sassy some day, try to use it. It's really amusing to watch the person you're asking the question to think that you're a complete moron one second and then realize you're only kidding in the next moment. Just make sure you know who you can say it to, or it could land you in a whole pile of trouble :)