Tuesday, May 31, 2011

I'm really looking forward to a week off.

It will come as no surprise to anybody that people can be stupid.

I wonder why it still surprises me sometimes. The level of inexcusable, inexplicable, unbelievable stoopid I've encountered lately has left me looking forward to having holes punched in my belly. At least I'll get a nap, and at least I'll be at home for a week.

People, please:

If we tell you Papa mustn't drive after his stroke, that means Papa must not drive. Not "not drive long distances" or "not drive a Toyota" or "not drive to the store." It means that Papa now lacks decision-making ability, part of his visual field, and most of the use of one side of his body, and Must Not Drive. Even a big car, even for short distances, even in town.

This is a hospital. It's in the inner city, on a busy street. People come in and out and through on a regular basis. Some of them have business here, while some are merely cutting through our lobby in order to shorten the trip from point A to point B. We can't predict who's going to be coming in and out. Therefore, it's a very bad idea to leave your computer, your iThingy, your purse (no, I am not kidding), your children, *whatever*, unsupervised for long periods of time in the ground-floor lobby.

Likewise, if you choose not to reveal that you have valuables on your person (which means I can't inventory them and lock them in the safe), I am not responsible if your aunt, cousin, ex-husband, or daughter takes those valuables away while you're laid up in the bed. It says so right there on the admission sheet.

No matter how long ago you had that reaction to that drug, it's still an allergy. If penicillin made your face swell up and your breathing get funny six months ago, it's likely to do the same again. Please tell me these things. While we're at it, tell me if you have a food allergy. Some things I can predict, like that the guy whose rabbi visits twice a day might not want bacon on his breakfast plate. Other things, like that you're allergic to nuts, are not immediately obvious.

If Mama is ninety-plus years old with multiple medical problems and occludes the big arteries in her brain, then converts to a hemorrhagic stroke, it might be time to let her go. I do understand that this is a horrible shock to you and that it's tremendously difficult, but please: you are not doing her any favors by leaving her on a ventilator and pressors and a tube feed for three weeks. There is no Mama in there any more.

Check a blood sugar before you give insulin to your patient. That way I won't be trying desperately to start an IV in a stenosed, disappearing vein that belongs to the person with a blood glucose of 20. (Jesus H. Creeping Roosevelt: how many times do I have to say this?)

And, finally: I know I am strong. I know there's a certain amount of noblesse oblige that comes with being stocky and squat and able to lift heavy things. That doesn't mean, however, that if you ask me to "help" move your patient from the bed to the chair, you can stand by quietly as I lift your patient bodily, pivot him (with only toe-touch to the floor on his part), and place him in the chair by myself. Although I am so feminist that I glow in the dark and kill noxious weeds at twenty paces with only a glance, I will be doubly pissed off if you're a man and bigger and stronger than I am. Help means help. Picking up a person and slinging him over my shoulder means my back hurts today.

Do you suppose, if I stay under general anesthesia long enough, that the collective IQ of the planet will have gone up a few points by the time I wake up?


bobbie said...

Unfortunately, I seriously doubt it...

Penny Mitchell said...

My staying under general for a while in December of 2010 didn't make the world any smarter in 2011. Sorry.

messymimi said...

Well, while you are under, you can dream.

One doctor asked an ER patient if she had ever been given penicillin before. She said yes, so they gave her a dose. A few hours later she heard them talking about how likely it is for a patient to have such a bad reaction in those circumstances, and she chirped up quite cheerfully, "Oh, don't worry, doctor, it happened just like that the last time, too!"

As for the driving, and leaving kids unattended -- don't get me started.

danielle said...

"Do you suppose, if I stay under general anesthesia long enough, that the collective IQ of the planet will have gone up a few points by the time I wake up?"

I can only pray

Lynda Halliger Otvos (Lynda M O) said...

You deserve a week off, my friend, do enjoy the peace.

Bardiac said...

No, alas. But be safe and take care because we can't afford to lose the folks with basic common sense, especially if they also write a blog I enjoy. (Because it's all about me!!) (Not really.)

Allison said...

Nope, not a chance of it. Enjoy the time off.

RehabRN said...

Re: the insulin, I have the same thing...I just want to say, "Duh!"

They do the same thing with BP meds. If their parameters are not in range, do not give it. Do a BP right before you give it, then work on it based on those results, not the BP they got this morning at 0600 and it's now noon.

It's so freaking annoying!

birdergirl said...

Unfortunately, Jo, you can't cure stoopid. Good luck with your anesthesia and teeth/hair thing removal.

Heidi said...

Who the f doesn't check a sugar before giving insulin? I mean, besides some of the maroons I work with.... yeesh.

terri c said...

And, if you do the BP, and the patient TELLS YOU that her BP runs high when she is in pain, then after the morphine PCA is started, do the BP *again* before giving the 40 of Lasix. (yep, saw this, the patient's BP dropped to 90/50 after the Lasix...)

Jo, best luck to you with the Animal-viction and rest well.

Annie Knowby said...

HAH! I sometimes want to experience some muscle atrophy so i'm not the go-to for movin' folks. Hmph.