The last two days at work have been...well.
Mister Annoying Screaming Man came back a*gain*. Mr. ASM is one of those frequent-flyers who has some dementia, though not enough to keep him quiet and compliant, and who does things like leave his walker across the room at home and take repeated face-plants into the linoleum. The first six or seven times he came back, it was cute. It's not cute any more.
I took his care over about an hour before my shift ended and went to start an IV. He's been in the hospital before. He's been stuck before. He knows the drill, remembers it, knows he has to have a saline lock in his arm. Why, then, when I pierced his skin with the needle, did he scream and dope-slap me on the back of my head?
I jerked, the IV start needle ripped upward through his skin, and blood splattered my face and scrubs. That made a nice contrast to the vomit, feces and urine I'd already been splattered with.
Earlier that day I'd had the sort of patient everybody dreads--a brittle type I diabetic who refuses to manage his blood sugar or stick to his diet. There's a certain type of person you know is going to be trouble, usually shortly before he goes in to DKA or his glucose dumps down into the teens, and this was that guy. After a hearty breakfast of five (!!!) glazed donuts, coffee with sugar, and some chocolate milk, he started feeling a little tetchy. He was kind enough to unload breakfast on my shoes--thank God I was wearing my old Danskos--and my scrubs. Lovely.
The vomit was joined a short time later by shit. And sweat. There's some Universal law somewhere that says that isolation patients with nasty intestinal bugs must a) weigh something on the wrong side of 400 pounds, and b) want their thermostat turned up to 85. You know those plastic isolation gowns? They don't protect worth a damn.
There was no isolation gown nearby when my seriously demented patient yanked out her Foley catheter and started waving it around, speckling everybody with pee. Of course, she was on pyridium.
Chef Boy floated the idea of moving to Brazil and running a B & B last night. You know, there are times when moving to the Southern Hemisphere, learning Portugese, and living in the middle of nowhere tending orchards and sheep seems like a really fine idea.
Oh, and I did get the IV started on the second try. A combination of barely-controlled rage on my part and several towels wrapped around his bleeding hand kept him quiet.