Thursday, November 13, 2014

This was my week:

On Monday, my Sonicare toothbrush bit the dust. I'd been limping it along for months, and it finally coded and couldn't be revived.

Today, I had a decision to make: I had money in the budget either for a new Sonicare or a bottle of Laphroiag.

I chose Scotch. Oral care, I am not up in you right now.

And this is why:

On Tuesday, I was minding my own business when I saw a coworker hurpling cheerfully down the hall with what looked like a liter suction container full of bile. I shook my head and blinked twice, and damned if it wasn't a liter suction container full of bile.

Now, normally when one is faced with a quart or more of straight-up digestive fluid that has to be removed from, say, a patient's room, one gets a bottle of this nifty fluid-solidifying stuff and takes it in to the room where the straight-up digestive fluid is. One then dumps the solidifying stuff into the container of SUDF, waits until it solidifies, and tosses it into a biohazard bag.

One does not bop down the hall, hugging the still-liquid, suctioned-out contents of a stranger's stomach.

So I stopped the coworker, and took her into the storage room, and grabbed a bottle of solidifying stuff. And then told her how to handle the liter of green corrosive goo, and what to wipe down, and where to throw it all away.

And she argued with me. She wanted to take it into the nurses' breakroom and deal with it there, because you can't deal with that stuff at the sink in the clean utility room. She argued, and continued arguing, until my hero the unit secretary came in and laid down the law.

Wednesday was a blur. I think it had something to do with more than one bottle of wine, consumed such that I maintained a happy glow throughout vacuuming and napping and cooking dinner. I know there was some Doctor Who involved. (Does anybody else get a creepy vibe from Danny Pink? I sure do.)

Today that same coworker, who is a nurse (well, a nurse who hasn't been a nurse in, like, twenty years) but who has a non-nursing job, approached me with a sunny smile. Here is what she said, verbatim, with no prelude:

"As soon as the car arrives, they can go to rehab!"

What car? I asked. And who, and where, and how?

Turns out she was talking about a patient she'd been rounding on and case-managing for *for a week.*

Dude has a dense hemiplegia and is globally aphasic. He's also incontinent, has no truncal control, and requires frequent suctioning. He's a max assist with two people to sit edge of bed and can't tolerate an hour in a geri-chair.

And she wanted to send him to a rehab four hours away in the family car, with only his wife and son (no suction, no help) to watch him.

And she argued when I said we needed an ambulance.

Unfortunately, the Hero Unit Secretary wasn't working today. I was forced to say, "You are out of your effing MIND" before she would stop arguing and call the ambulance company.

Why is bile green, anyhow? What, chemically, causes that to happen? I never learned that in school.

Anyway, tonight it's Scotch and muscle relaxants (don't try this at home, kids!) because I also threw my back out this week, and then bed. I'm hoping I don't get awakened by Playful Mongo at some ungodly hour of the morning.

8 comments:

Jilly said...

Long time reader who has never commented. Your co-worker sounds like a nightmare nurse I used to work with, who took great pleasure in being a contrarian.
The green colour of bile comes from the breakdown of bilirubin, and the stuff that helps that process (biliverdin,I think).

KirstenJL said...

Idiots will argue....

Stefanie said...

I'm not argumentative when someone's trying to tell me a new and better way. Was out of nursing 20 years before I started up again 4 years ago. Like it better this time. But... I've never heard of/seen this solidifying stuff! We just throw said container in the trash. :( Sorry if that horrifies you. Lots has changed in that 20 years, and don't I know it.

And I don't know why bile is green either.

Scrub Ninja said...

The bright, grassy green of straight bile is a pigment called biliverdin, which comes from the breakdown of heme.

That is a precursor to the more familiar bilirubin, which is yellow, and responsible for jaundice. Together they also cause the funky yellow-green color of old bruises.

Bilirubin gets broken down further into stercobilin, which is brown, and is responsible for the color of poo.

RehabRN said...

jo:

Oh, no! I love when patients (or lazy arses case managers) think they can get a patient transferred by family to save a buck.

My personal favorite, "what? They need oxygen." said case manager. "I thought they just had a trach."

Me: "Didn't you notice the oxygen canister on his/her wheelchair when he/she came to talk to you? He/she's on oxygen 24/7, not just as needed. They will need a life support ambulance in case they need suctioning, too."

Sometimes, I wonder...

Anonymous said...

If you're inclined to get a new electric toothbrush, a good friend who is a dentist recommends Oral B Triumph with the floss-action head. You still have to floss, but she personally has experienced the improvement of this toothbrush vs. Sonicare, which she used to recommend. (Her house was hit by Hurricane Ike right around the time she bought this brush. She went several months with getting only a few hours of sleep per night and only having time to use her brand-new Oral B Triumph once per day, and her teeth were better than they were when she used the Sonicare twice a day.)

Anonymous said...

Danny Pink *is* creepy, and not even in a good way.

I kinda feel like Clara is a completely new character, too. One I don't really have respect for.

I love Capaldi's Doctor, though. He seems so perfect in the role...he is exactly what I would expect such a creature as the Doctor to be. He is neck and neck with Eccleston to be my favorite Doctor.

Anonymous said...

I love my older Sonicare toothbrush. Sometimes they can be resuscitated by leaving it turned on for 15 minutes after the low charge blink comes on. Then put it on the charger for about an hour, then discharge. Repeat. These things are also dandy for wound debridemnt ( : However, They are too cheap to be classifed as medical devices