Thursday, June 23, 2005

Whoring and hobbying.

Food whoring and hospital hobbying, that is.

Remember the corn I got? I got more from the farmer's market and mixed it up with black beans and diced tomatoes and some broth from the Dead Chicken of the other night (this was older corn that could be treated this way) and made SOUP. Mmmm. Soup. (There, Kit, is your Corn Whoring.)

As for the hospital hobbyist, here's the story. It's instructive to note that all the time the residents and attending were writing orders, we the nurses were the ones that had to deal with this patient.

Every once in a blue moon, you meet a person with an incredible tolerance for pain medication. For those of you who aren't nurses, the Painkiller Of Choice for a lot of people with a high tolerance or a big addiction is something called Dilaudid.

Whereas morphine and Demerol are dosed in milligrams, Dilaudid is dosed in tenths of milligrams. It's not only whoppingly effective, but it's whoppingly concentrated. Keep this in mind: a patient-controlled pain pump filled with morphine is dosed one milligram of drug to one milliliter of fluid. Dilaudid is dosed 0.2 milligrams of drug to milliliter of fluid.

With addiction (I'm not going to use the word "tolerance" here, since it's not appropriate) comes other problems, most of them psychological. Sometimes it's bad enough that our very-pampered MDs will skip seeing a patient daily, just so as not to have to deal with their weirdness.

Which brings me to the Champion Hospital Hobbyist: a person who spent six weeks in our facility with a wound infection, who was on a Dilaudid pain pump with a setting I had to read twice to believe, who got additional narcotic painkillers and Dilaudid boluses every hour, and who still was able to get up, go down seven stories, walk out to the parking lot, and smoke.

(For the nurses, the pump setting was 0.4 basal, 0.6 q 6 minutes, 30 mg q 4 hour lockout, boluses q1 prn. Which was increased every few days as boredom set in. Along with fifty of Phenergan q2 and the occasional Lortab.)

This patient was crazy enough that the attending had left it to the residents and nurses to handle things for six weeks. We were all wondering if Said Patient was simply going to move in, since there didn't seem to be anything wrong that we had to deal with, when I finally asked Attending the burning question on everyones' minds:

"So...this person's been here a month and a half, and we haven't really done anything. How many nudie pictures of you *do* they have at home? 'Cause that's the only reason I can imagine that we're keepin' 'em."

Champeen Hospital Hobbyist was gone the next day.

5 comments:

Kelly said...

Bada bing bada boom.

Kelly said...

Get some trackbacks, Jo. I wrote aboutcha.

shrimplate said...

Bet ya' a nickel Champ showed up on the doorstep of another hospital hours later.

HypnoKitten said...

mmm.. corn soup! (fresh corn is so excellent in anything!)

Great story. I love the nudie pictures comment. I certainly hope you really said that to him - he should be ashamed at leaving you to deal with this guy for so long.

Jo said...

HK--

You gotta know the doc. We talk about such things as carburetor problems in his motorcycle all the time.

Snark is a valued resource at our hospital.