Pt. came in c/o of severe vag bleeding over the past 2 months or so. Was feeling weak, nauseous and generally "ill". ER doc talked to OB and had pt. put on their list. She was going to be admitted to OB.
As I am still orienting, I asked my preceptor "C" for help as I was about to go into the pts. room. As I was about to enter, a lady walked out and in passing told me, "Oh, her pads were soaked. So I cleaned her up a bit and changed her".
As I'm setting up supplies to draw more blood for lab work, I casually asked C "So, who was that?"
"Dr. O. She's an OB attending".
*Blink Blink*
"Did you say attending?"
"Yeah. Why?"
"Nothing", I stammered; "I'm just not used to having docs - especially attendings - clean up patients... I guess".
C shrugged her shoulders, "It's different down here".
I guess it is. I think I might actually like working here...
Speaking of different and cleaning people up, The Chief Complaint of the day award goes to:
"Soiled himself. Here to be cleaned up".
No, it wasn't my patient and I wish I had the time to look up further details [or not. HIPAA violation, non?]- but that really was the "Chief Complaint" as entered by the triage nurse into the system.
And no, I'm not making that up...
Saturday, May 31, 2008
Saturday, May 17, 2008
The Things They Carry
"Hey Spook! You're back so soon?", teased J.
I snort. "I live here. I eat out of the vending machines and shower in the ER decon room. Didn't you know that?"
J rolls her eyes. "Yeah right! Seriously though, you need to take it a little slow. Don't be no hero Spook. I don't want you burning out on me".
I chuckled at that. Those were the exact words I used to admonish J, chiding her for working too much overtime.
It wasn't that simple - or maybe it was and we were just too young, too naive and too dumb to see it. Working night shift on our floor was dreadful - since we were always understaffed, constant calls from managers and charge nurses begging us to work an extra shift (or two or three) was "routine". Neither one of us bothered to make out a schedule since it kept getting changed every other day. Nor did we bother asking for time off because we'd be treated to the whole pouty, whiny drama of our chronic staffing problem. In fact, staffing is so bad that over 90% of the time, HALF the nurses working nights on the floor were float pool nurses.
"Yeah well, not before your wedding anyhow. I mean, someones gotta eat all that ice cream!"
J poked her tongue out and made a face. We both laughed.
I took a quick look at the assignment sheet and compared with the patient board. We were both split and had patients all over the floor. Not only that, but I saw that the patient assignment was patchy - people had simply been put into whatever room was available. I let out a short whistle, "Wow! This is nuts. Musta been really busy today"
RM, one of the second shift nurses answered in a tired monotone without looking up from the computer screen, "15 surgicals, 14 discharges so far Spook. We're not done yet, since 3 of 'em are still down in PACU. It was a freaking revolving door up here today".
"Damn! We're full." I sigh. "I bet that makes the suits happy... wait! MS is back??! Didn't she just get discharged last week?"
CM, another evening shift nurse looks up and says "she was my patient. Didn't listen to report yet? Just want me to give a verbal?"
"Yeah sure. Lemme grab my stuff and I'll be back".
I hurry over to the staff room and get ready. CM plops down on the chair in front of me. She looks beat. Tired. That’s a bad sign – no matter how bad the day got, she was usually very cheerful.
“C, hang on a second”.
I get up, go over to the counter and get a glass. I fill it with cool water and hand it to C.
“Here, drink this”.
She looks at me. Her mouth forms no words but the gratitude in her eyes is genuine.
Glass of water never felt so good huh? When was the last time you had an uninterrupted 10 seconds to have a glass of water? Musta been a real bad day…
“C, listen to me. I want you to give me report, put your stuff in your locker and go straight home. Don’t worry about if you did this or that. Leave it to me. Clear?”
C nods her head, too tired to argue or protest.
Quietly, I take report.
There’s a lot to be done. 3 dressing changes and two IVs that need to be started... besides the other assorted "usual stuff" - assessments, med passes, chart checks etc. etc. etc.
A couple of hours into the shift and progress was bitter and slow. Soon as I finish one job, two more seem to appear. It seemed more and more likely that I wouldn't be able to leave on time at shift change.
I was scurrying back to the nurses station to gather supplies to try and start a line on someone else’s patient when I passed MS’s room. I thought I heard quiet, muffled sobbing. The door was barely ajar and the room was dark. I paused.
There it is again! What’s going on? I knock softly and tip toe into the room.
MS is lying in bed, with tears streaming down her face. Crying and sobbing. The trained professional part of me quickly analyzes her for any obvious signs to explain her discomfort. I see no obvious signs. I quietly walk over to her bed and sit down at the edge. I take her hand in mine and give it a gentle squeeze.
We exchange no words. I sit quietly while she cries.
Finally, she blows her nose on a tissue and looks at me with bloodshot, tired eyes and a worn, haggard face.
“I’m sorry”.
“For crying? Don’t ever be. Human beings cry.”
“I’m scared. I’m hurt. I don’t know what to do”.
Silence. A pause.
“I just got off the phone with Dylon. My older son. We had a fight…”
The tears begin again.
“We had a fight and he hung up before I could soothe things over. It was over *sob* a stupid cell phone bill. *sob* Now I’m trying to call him and he won’t answer his phone. I just want to tell him that it’s OK. That I still love him. I want to hear him say it. I want hear him say it. I want to hear him say that he still loves me.
I’m lying here and my kids are by themselves out there. I’m such a bad mother!”
She’s crying again. I don’t say a word. Just slowly stroke her arm. My pager starts vibrating. I hurriedly turn it off.
“MS, kids are resilient. He’ll turn around.”
“I know he will. He’s my boy after all”. A wry smile. “But will I have time?”
We both look at each other. The anguish on her face is unmistakable. I lean over, wrap my arms around her frail, disheveled body and give her a gentle hug.
And I just sat there as big fat tears rolled down her cheeks and wet my shoulder as MS cried her heart out.
After what seemed like an eternity, she slowly pulls away and wipes her tears.
“M, nobody knows the answer to that question”.
A wan smile. She nods. “Yes. That’s true, isn’t it?”
“Thank you for sitting with me. I know you have other patients who need you”.
I squeeze her hand and smile. “I’ll be in shortly to check on you, OK?”
I slowly turn around and walk out that room.
Here lies MS. A woman barely into her 40s. Trying bravely to raise her children the right way, all by her lonesome self in this world full of people. Who has just been told today that her cancer is terminal and has spread to her liver, lungs, pancreas, stomach, intestines … everywhere. Who despite her constant physical pain and the suffering brought about by cancer treatment, still worries about being a bad mother.
A tear rolled down my cheek.
Then a second.
How wretched is human suffering!
I walked to the desk on autopilot and sat own. Put my face in my hands and closed my eyes; trying to clear my head. Somewhere in the distance, a part of my brain is trying to tell me the phone is ringing but I’m powerless to act.
I feel a hand on my shoulder and look up.
“You ok, Spook?” asks J.
I smile and nod my head. “Allergies”, I lie.
She smiles. She knows it’s a lie and that I have no allergies, but lets it fall for now.
Deep breath. A shake of the head.
Back to work…
Update: MS finally passed away on September 8th. She was at home, with her family and friends.
I snort. "I live here. I eat out of the vending machines and shower in the ER decon room. Didn't you know that?"
J rolls her eyes. "Yeah right! Seriously though, you need to take it a little slow. Don't be no hero Spook. I don't want you burning out on me".
I chuckled at that. Those were the exact words I used to admonish J, chiding her for working too much overtime.
It wasn't that simple - or maybe it was and we were just too young, too naive and too dumb to see it. Working night shift on our floor was dreadful - since we were always understaffed, constant calls from managers and charge nurses begging us to work an extra shift (or two or three) was "routine". Neither one of us bothered to make out a schedule since it kept getting changed every other day. Nor did we bother asking for time off because we'd be treated to the whole pouty, whiny drama of our chronic staffing problem. In fact, staffing is so bad that over 90% of the time, HALF the nurses working nights on the floor were float pool nurses.
"Yeah well, not before your wedding anyhow. I mean, someones gotta eat all that ice cream!"
J poked her tongue out and made a face. We both laughed.
I took a quick look at the assignment sheet and compared with the patient board. We were both split and had patients all over the floor. Not only that, but I saw that the patient assignment was patchy - people had simply been put into whatever room was available. I let out a short whistle, "Wow! This is nuts. Musta been really busy today"
RM, one of the second shift nurses answered in a tired monotone without looking up from the computer screen, "15 surgicals, 14 discharges so far Spook. We're not done yet, since 3 of 'em are still down in PACU. It was a freaking revolving door up here today".
"Damn! We're full." I sigh. "I bet that makes the suits happy... wait! MS is back??! Didn't she just get discharged last week?"
CM, another evening shift nurse looks up and says "she was my patient. Didn't listen to report yet? Just want me to give a verbal?"
"Yeah sure. Lemme grab my stuff and I'll be back".
I hurry over to the staff room and get ready. CM plops down on the chair in front of me. She looks beat. Tired. That’s a bad sign – no matter how bad the day got, she was usually very cheerful.
“C, hang on a second”.
I get up, go over to the counter and get a glass. I fill it with cool water and hand it to C.
“Here, drink this”.
She looks at me. Her mouth forms no words but the gratitude in her eyes is genuine.
Glass of water never felt so good huh? When was the last time you had an uninterrupted 10 seconds to have a glass of water? Musta been a real bad day…
“C, listen to me. I want you to give me report, put your stuff in your locker and go straight home. Don’t worry about if you did this or that. Leave it to me. Clear?”
C nods her head, too tired to argue or protest.
Quietly, I take report.
There’s a lot to be done. 3 dressing changes and two IVs that need to be started... besides the other assorted "usual stuff" - assessments, med passes, chart checks etc. etc. etc.
A couple of hours into the shift and progress was bitter and slow. Soon as I finish one job, two more seem to appear. It seemed more and more likely that I wouldn't be able to leave on time at shift change.
I was scurrying back to the nurses station to gather supplies to try and start a line on someone else’s patient when I passed MS’s room. I thought I heard quiet, muffled sobbing. The door was barely ajar and the room was dark. I paused.
There it is again! What’s going on? I knock softly and tip toe into the room.
MS is lying in bed, with tears streaming down her face. Crying and sobbing. The trained professional part of me quickly analyzes her for any obvious signs to explain her discomfort. I see no obvious signs. I quietly walk over to her bed and sit down at the edge. I take her hand in mine and give it a gentle squeeze.
We exchange no words. I sit quietly while she cries.
Finally, she blows her nose on a tissue and looks at me with bloodshot, tired eyes and a worn, haggard face.
“I’m sorry”.
“For crying? Don’t ever be. Human beings cry.”
“I’m scared. I’m hurt. I don’t know what to do”.
Silence. A pause.
“I just got off the phone with Dylon. My older son. We had a fight…”
The tears begin again.
“We had a fight and he hung up before I could soothe things over. It was over *sob* a stupid cell phone bill. *sob* Now I’m trying to call him and he won’t answer his phone. I just want to tell him that it’s OK. That I still love him. I want to hear him say it. I want hear him say it. I want to hear him say that he still loves me.
I’m lying here and my kids are by themselves out there. I’m such a bad mother!”
She’s crying again. I don’t say a word. Just slowly stroke her arm. My pager starts vibrating. I hurriedly turn it off.
“MS, kids are resilient. He’ll turn around.”
“I know he will. He’s my boy after all”. A wry smile. “But will I have time?”
We both look at each other. The anguish on her face is unmistakable. I lean over, wrap my arms around her frail, disheveled body and give her a gentle hug.
And I just sat there as big fat tears rolled down her cheeks and wet my shoulder as MS cried her heart out.
After what seemed like an eternity, she slowly pulls away and wipes her tears.
“M, nobody knows the answer to that question”.
A wan smile. She nods. “Yes. That’s true, isn’t it?”
“Thank you for sitting with me. I know you have other patients who need you”.
I squeeze her hand and smile. “I’ll be in shortly to check on you, OK?”
I slowly turn around and walk out that room.
Here lies MS. A woman barely into her 40s. Trying bravely to raise her children the right way, all by her lonesome self in this world full of people. Who has just been told today that her cancer is terminal and has spread to her liver, lungs, pancreas, stomach, intestines … everywhere. Who despite her constant physical pain and the suffering brought about by cancer treatment, still worries about being a bad mother.
A tear rolled down my cheek.
Then a second.
How wretched is human suffering!
I walked to the desk on autopilot and sat own. Put my face in my hands and closed my eyes; trying to clear my head. Somewhere in the distance, a part of my brain is trying to tell me the phone is ringing but I’m powerless to act.
I feel a hand on my shoulder and look up.
“You ok, Spook?” asks J.
I smile and nod my head. “Allergies”, I lie.
She smiles. She knows it’s a lie and that I have no allergies, but lets it fall for now.
Deep breath. A shake of the head.
Back to work…
Update: MS finally passed away on September 8th. She was at home, with her family and friends.
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