Tuesday, December 30, 2008

Why I prefer vented sedated patients.

For the non-medical or people reading this...might be a little hard to understand but I will do my best to translate.  

The other night at work was probably one of the worst nights at work that I can remember.  After 3 days of decompressing from that day I can finally write about it.  It was my fourth night of the week.  I had my same patients as the night before-this was good. One was going to be transferred out.  This was fine but going to be busy since I get to be the one to get the next new patient.  The other patient was extremely critical, vented and on 7 gtts.  Two were pressors and if the bag ran out she would literally die.  So she was busy...this was ok, things were under control.  
Around midnight my new patient comes.  You are going to love this.  She overdosed on two of her bipolar medications...while she was in the hospital.  Ok, so she was a little drowsy and needed closer monitoring in the ICU.  As the transporters are wheeling her to her room she is shouting that "I better have a @#$% TV or I am leaving."  We were all fine with her leaving but unfortunately she was a suicide risk and we would be held legally responsible if she was allowed to leave.  Anyway, as she staggers off the stretcher to the room, she again amongst other colorful words states she wants a room with a TV.  "Sorry Miss, there are no other rooms available."  

In the mean time as she is drinking her Pepsi she starts to wander into my another patients room to do who knows what.   I take action and guide this lovely bipolar lady by the elbow away from where she is going.  The woman freaks and says, "don't you touch me,".  Then it happened, remember that Pepsi?  Well, she threw it all over me.  Head to toe I am covered in  high fructose corn syrup, sugar, and whatever else is in Pepsi.  I am more surprised than anything and I firmly escort BL to her room then call Security.  In the mean time every one else seems to have disappeared.  I don't want to leave the area because she is too unpredictable.  Some one shows up and wonders "what the hell happened to you."  As I notify the airhead doctor (AD) who sent me this "lethargic" OD patient to can walk, talk, A&Ox3, be dead accurate in Pepsi aiming and demand a TV while yelling at the top of her lungs on the way in, I get to watch every one take a good look at my high fructose saturated head and body to show that I am not joking since no one was there to witness.  Every one tries to encourage me by saying, "It could have been a urinal," True.  I think BL was just fine to stay where she was and have a sitter like every other suicide pt.  So after washing out my scrubs and putting on these ridiculously large paper scrub things BL calms down and everything is back in order.  Or not.

It gets better.  I find out that AD thinks BL might have PCP (an HIV/AIDS pneumonia that can be contagious).  So she needs to go to an isolation room until its ruled out.  Thanks AD for thinking of this after I have all of her backwash drying up on the side of my face and inside my ear.  Ok take a deep breath.  Charge nurse, after another 2 hours, figures out what room she has to go to since there are no open rooms.  I have time realize that my hair on one side is very crusty.  I go to a shower and rinse it out as I am overwhelmed with scenarios of how I should have taken BL out and banged her head in the floor and did what she wanted to do in the first place.  We do the room swap and I end up trading patients with another nurse because of the geography of the rooms.  BL says she is sorry about the Pepsi incident.  "You are?"  Then I strangle her to death with with her O2 tubing.  Actually I just said, "that's not a very nice thing to do, it really dampened my day," no pun intended.  Hope you get your TV, Bitch.
Glad to be rid of BL, but instead I get a crazy one eyed Hispanic guy (COEHG) who thinks he has to go home and is very confused.  So they restrained him for his safety...fine what ever will help.  By this time, the other patient...the one who actually is an ICU patient...died because her gtts ran out.  Well, ok, her gtts didn't run out and didn't die but she has been badly ignored because of BL.  She I tend to her for awhile.  I leave her room to get a few things and pass by COEHG to find him covered in blood and on the floor.  Well, ok, I guess I am getting a little carried away.  Really he yanked out his IV, O2 was off as was sating a little low, blood was only on his arm and he was only trying to get out of bed and not on the floor yet.  

Where is everybody?  Am I the only one working this in this unit?  

Wait, I cant believe I didn't tell you yet about the Hispanic lady (HL) whose room was next to my 2 patients.  HL accused me and another nurse of trapping her somewhere.  Through out this whole night of disorder, HL would shake a scolding finger and yell Spanish obscenities through her bipap at me when ever she saw me.  Actually I have no idea what she was saying, I don't speak Spanish.  But from knowing the universal language of all people she was telling every one that I was the  devil. 
Any way the night ended day shift came, late as always, I went home.  I took a nice hot shower to rinse away the rest of the Pepsi on the back of my neck.  Went to sleep and dreamt of me strangling BL.
Needless to say the night was a bad one but could have been worse.  But now you may understand the title of this blog.  Sedated vented patients compromise much easier.


Ren said...

Speaking of vented sedated patients... I just want you to know that I could never do your job! Hell no!
And I also want to say, since this year is almost, finally, behind us, how much I appreciate(d) you and every nurse out there. Not only did you help save my life (whether you believe this or not), you helped me through the worst moments of my life. I might have been a "job" but you made me feel like a person.
So, thank you Rachael. May your 2009 bring you new adventures, knowledge and joy!

...and Pepsi-Free patients!


Life 102 said...

This was hilarious! I laughed very hard, of course I wouldn't have been laughing had I been in your shoes but at least you can look back now and laugh, right? At least your other patient didn't die, what a relief! (c:
Happy New Year!
love jenn

mommy nurse said...

Hey! Great post! I wish we could say all of the things you thought to our patients, sometimes! Like Jenn, I laughed and visualized the whole story as you told it! I'm also glad your bag never ran out! Keep plugging, you are an awesome nurse!

MoMologette said...

OMG!!! I just laughed out loud here at work too!! That was a great "story", sorry it had to be your reality. I'm glad its all behind you and no one died- at your neglect or homicidal frustration. You rock Rachael!!

Jennifer said...

Glad to hear that the nursing on the other side of the fence isn't any greener...or drier. (I was urinated on last week and it wasn't nearly as funny a story.)

Bob Fomenko said...

LOL... its the job.
Been at it for 25 years and it don't get any easier... actually it gets worse...