Monday, December 17, 2007

Weekend from Hell

Well, that'll learn me to wish for something exciting to happen at work so I can write about it :/

Let me first say this disclaimer: whatever my opinion of a patient may be, they all get the same amount of respect and care from me as do my favorite patients. I believe I have gotten very good at schooling my facial expressions and not showing my frustration too much. I also do not get angry with the patient themselves (except in the rare circumstance an alert and oriented male patient thinks it is all right to grope me), and my attitude of anger and hatred is at the situations and NOT the patients themselves.

Okay. On to the ranting and venting.

It is my great belief that patients with psychological issues do not belong on a cardiac floor, even if they are having a cardiac issue. We just do not have the resources to care properly for them. Let me tell ya about the group of patients I had this weekend:

My day starts off bright and early with my first patient locking herself in the bathroom for an hour. Whose great fucking idea was it to put locks on the INSIDE of a bathroom door in a hospital?? I cannot even begin to tell you all the things that are bad about that. Coding behind a locked door in a bathroom is about as bad as it can get. Anyway, apparently we are all trying to kill her, and she is angry with the nurse she had yesterday for leaving her at the end of her shift. Oh Gods the horror of a nurse actually going home!! Maintenance is called and threatens to take the door off the hinges. Patient with paranoid delusions comes out of the bathroom only after we promise that no male will enter the room all day.

So guess who gets to give this woman a bath? That's right. Moi. And boy does she need one. Explosive diarrhea + yeast in skinfolds + sweating for a week = smelly patient. So I get her in the shower and proceed to get aforementioned nastiness off of her. Bless the saint who created Latex gloves. She gets out of the shower smelling like fucking roses, let me tell you. A gallon of baby powder and lotion later, she's happy, smells good, and is having another bout of explosive diarrhea. I'm trying to remember that it's not this poor lady's fault as the room I had smelling so good now fills with eau de poop. After this episode is done (and I have wiped her ass because she cannot reach it), she gets situated back in her chair with a tall glass of Diet Dr. Pepper. Having done my duty, I continue to the next.

Here we have a woman with multiple personalities. She's pretty ill, even by my standards. She's in for an abdominal abscess (on a cardiac floor..../boggle) and has at least 3 tubes coming out of her huge abdomen. I say at least because every time we turn this woman over, we get another tube. In report from the offgoing night shift, we found out that she's been depressed and crying all night because she thinks she's messed up her life and will never get well. Twenty days in the hospital will do that to you.

She was probably fairly heavyset to begin with, but she's retaining so much water that she's probably twice the size she was when she came in. Remember Violet Beauregard in the original Charlie and the Chocolate Factory movie? The one who turned into a blueberry? That's pretty much what this woman looks like: little bitty head on a huge bloated body. Her feet and legs are so swollen there is no possibility of getting her out of that bed. However, as the nurse and I bathe her (twice, because she pooped while we were changing out sheets), we find that she's getting bedsores all along her back and bottom - she needs a special bed and mattress.

Luckily for us, we live in a time of extreme technology and have a lift that can get her clean off the bed without any of us breaking our backs. So, new bed comes, we put her in the lift (she's crying the whole time, btw. "I'm so sorry", "I'm not a bad person", heartbreaking stuff like that so we all want to cry for this poor woman), get her in the new bed with the inflatable mattress, clean her up again (more poop - abdominal abscess, after all), and I'll be damned if the lady didn't sleep like a log until the shift ended. Probably the best sleep she's gotten all along, because nobody else thought to get her a larger bed with a special mattress for her larger body. It's almost sick how something so simple could have been done weeks ago to help her, but nobody even thought to because she was so mean the first few weeks we had her.

At this point I'm woefully behind on my assignments, so I bathe my two "normal" people right quick (both nice and familiar coronary artery bypass graft patients, hereafter referred to as CABGes "cabbages"). I say normal, but one was actually a surgeon who was proving the old adage "doctors make the worst patients". He was giving the nurse hell, but barely noticed me changing his sheets and getting his shower ready - also typical doctor behavior. I suppose it's fair to mention at this point that the cardiac surgeon on duty this weekend brought all the nurses donuts that morning - he's the only one that does that.

Anyway, now we come to the little old lady with severe Alzheimer's that's just gotten a CABG done. Now, my opinion on quality vs. quantity of life is for another post, but let me just say that this woman had no business getting a CABG, regardless of her mental state. She was 84, for God's sake. But, this particular surgeon (not Dr. Donuts) will give anyone a CABG if they've got the bucks for it. She was sundowning last night and yanked out her Foley catheter (OW), so we found out she's completely incontinent of urine. Wonderful. Our floor doesn't stock Depends, but luckily her family loves her and brought a big 'ol box of her personal Depends up to the hospital. However, this was after she had peed on me and the nurse while we were standing her up. To top it all off, it was particularly odoriferous pee. God bless the saint who thought to make nursing shoes impermeable.

She was a pleasant kind of confused, though. When she wasn't telling the male nurse he needed a spanking she would gladly give to him, she was chatting about her deceased husband and all her kids.

A round of vitals, fingersticks, and lunches later, afternoon has arrived. The day got better from there - the usual walking of patients that can walk, putting to bed for some rest and then getting back up for supper, and occasional successful trips to the restroom. Still, I ask for a different group of patients tomorrow - I do NOT want to do this morning over again.

So Sunday comes, and I really have a wonderful group of likable patients. The only wrench in the cog is a patient that refuses to communicate with me. He's trached, but he can speak pretty well and sign for what he wants us to do. He just won't for me. I have no idea what I did to piss him off, but he'll hit his call light repeatedly, and when I go in to see what's wrong, he looks at me. That's all. I go through my usual spiel, "Do you hurt? Are you hungry? Nauseated? Bathroom? Blanket? Water? TV on?" On and on. Nothing. No shaking head, no nodding head, just staring at me. As soon as I leave the room, saying I'll get the nurse, he hits the button again and again. The nurse is the only one he'll talk to, but the nurse was pissed at ME for some reason. That just made it even more frustrating - I'm having to deal with an irate coworker because some snob of a patient won't communicate with me. I just got to do a little extra for my other patients because I couldn't do anything for him, so it actually helped make my day better. I always feel better when I have the time to put a little lotion on somebody or tuck them into their bed because they're a little cold.

So all in all, Sunday wasn't too bad. Saturday had just sucked balls though. The next time I work is Christmas Day, so we'll see how that goes.

In the spirit of having to work on Christmas, here's a poem I stole from
Nurses' Christmas

T'was the night before Christmas, and all thru the floor
Lasix was given, filling foleys galore.
Stockings were worn to prevent emboli,
they came in two sizes, knee and thigh high.
The patients were nestled half-a$$ed in their beds,
while visions of stool softeners danced in their heads.
We in our scrubs, and they in their gowns,
Fashions created to hide extra pounds.

When down in the ER it became such a zoo
they called with admissions for me and for you.
They're coming, they're going, and they're all looking the same. My patience for patients is starting to wane.
Now call lights are ringing, the patient 400 pounds,
says-"Didnt get my pericare, now send my nurse down."

And now delegation seems the best plan,
We try to send others, to the needs of this man.
When what to my wondering eyes should appear,

But Santa himself and 8 tiny reindeer.
He says he comes from Central Supply
To bring us LR,NS, & D5.
The doctors then scribbled what no one could read,
Orders on patients, to measure their pee.
We try to decipher illegible words,
orders for patients, to guaiac their turds.

The new shift arriving, our day is now through,
How did stool & emesis get in my shoe?

We give them report and pass on the facts,
and tell them of duoderm lining the cracks.
And the nurses exclaim as they limp out of sight,
"Ativan to them all, and to all good night.!!!"

Friday, December 14, 2007

**First Post**

Okay so...a little hard to get started here. It kind of makes me nervous to know that anybody can read this, but I refuse to change my settings. You know, just in case my life gets really interesting at some point and I become famous like Dawn's blog "Because I Said So". However, while I have a great deal of respect for Dawn and love her blog do death, I really hope I don't have to have six children to become famous. Ouch. Just a husband is more than enough at this point.

My inspiration to start a blog comes from the fact that I'll be working full time and not going to school next semester. This'll be the first semester in my life since kindergarten that I haven't been in school, so it'll definitely be something different. I work at a local hospital on a cardiac unit, and my patients are definitely something else. I'm in school to be a Registered Nurse, so I thought it would be a good idea to work as a nurse's aide for awhile, and lemme tell ya - it's been some kind of interesting.

I decided it would make my work day more enjoyable, at least for myself, if I was making a good effort to find something worth writing about while at work. I also thought it would be interesting to come back and read later on in my life to see what I've learned and how I've changed.

I have a tendency to start things and not finish them, but these are my major ideas and goals for this blog :) If you're not me and you're reading this - I hope you enjoy yourself )