Wednesday, December 08, 2004

Odds and Ends and Drama

From Correspondent Tim, somewhere out there in the Worldwideinternetwebland, comes this very funny list of do's and don'ts for patients. Tim says "all of these would've come in handy had I known to tell my patients beforehand."

Some generalized advice for patients

1) ...ask if the large puddle of blood pooling under your disconnected IV is normal.
2) ...ask for help reinserting foley catheters if you pull them out.
3) ...use short chairs instead of tall barstools if you drink too much and have osteoporosis.
4) ...ask for help if you wish to amputate a body part BEFORE you start cutting.

1) ... tell the hospital policeman that you need to go get your gun.
2) ... steal the laptop computer I use to sign out your medications.
3) ... slam the Pleurevac in the door of the cab as you leave AMA.
4) ... barf on the nurse. (the biggie)


It finally happened

"It" being Nurse Jo coming down on another nurse like the crack of doom. "Goddammit" was probably an ill-advised thing to say. "Fuck" was certainly unprofessional. The screaming will surely be discussed and embellished in rumor for weeks to come...but the only thing I feel bad about is the fact that I'll have a whopping big meeting with the floor manager on Thursday.

There's something about being a nurse that makes other people think they can yell at you. I got yelled at yesterday seven times before noon--that's more than once an hour if you're keeping track, which I certainly was after Yell Number Three. The reason I was getting yelled at and complained to was the attitude and shoddy people skills of the nurse whose patients I got yesterday morning.

A very nice paraplegic guy was upset because he wasn't given enough in-and-out catheters to use all night. Given that he gets dysreflexic if there's more than about 200 ccs of urine in his bladder, catheters are important. He also didn't get antispasmodic medication (very important for spinal-cord-injury patients; the limbs don't just lie there, they spasm) or pain medication for most of the night. There were other problems too minor to go into here...but they add up.

Another patient's husband was upset about the lack of communication on the nurse's part vis a vis what was happening with his wife. The doctor on the case was upset by her lack of help. The doctors on the consulting team were unhappy that the patient had gotten a large enough dose of sedative to leave her obtunded for hours and still zonked the next afternoon.

And all this came down on me. I ran around for several hours making nice, trying to wake my patient up, and generally picking up the pieces. The nurse who left me with this basket of rabid weasels is a technically excellent nurse. She's the shit when it comes to starting IVs and doing paperwork, but her attitude toward any patient who doesn't sleep peacefully all night sucks.

I'd finally had it. After she'd started complaining once again about how big a pain in her ass the obtunded patient had been, I went into Screaming Harpy Mode and yelled. For about ten seconds, at which time I realized it was pointless. Any nurse who responds to the suggestion that she might've oversedated a patient just a *leeeetle* bit with the words "I have to give what the doctor orders, that's my job" is a nincompoop.

I should've used the word "nincompoop" rather than "idiot". I should've moderated my tone and spoken to her in a calm, professional manner outside of the tension of the report room. I should've taken into account what had happened to her that night to make her personality even more wretched than usual.

I should've ripped her arm off and beaten her to death with it there on the spot.

Addendum: I came home to find a message on my machine from this same nurse, asking me to call her so she could clarify something with me. "If you can't, it's no big deal" she said. So I didn't. It's three a.m. If anybody says word uno to me about my not calling back, I'll point out that I too have been dragged into the 20th century and own a cell phone. Call me on that.

Ooooooohhhh, I am *so* not looking forward to Thursday.

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