Seriously talented boobies

Had a hilarious patient over the weekend. She's a woman in her 60s with a mean streak a mile wile and a mouth like a trucker. I think she might be a lesbian too even though she's married. She told me she married her husband for his health insurance and he's an abusive a-hole. (case management is following up with her) The reason I think she might not be straight is because pretty much from the time I enter the room until he time I leave all she does is talk about how I look, and when I give her a shot or anything she says stuff like "sweetheart, with a body like that you can do whatever the hell you want with me!" It's way creepy, but I'd rather be on her good side than her bad side so I just blew off her comments.
So anyway, she was coming back from an echocardiogram and the transport guy and our matronly nurse's aide who looks like this:

were helping her get off the stretcher. (actually the nurse's aide looks EXACTLY like the old lady on the one Beavis and Butthead movie where they are on the plane and the little old lady gives candy a.k.a. caffeine pills to cornholio, but I couldn't find a pic of her :( ) Anyway, she was helping the trucker mouthed pseudo lesbian off the stretcher and the aide called me to "get in the room QUICK, and look at her IV" I went in and her IV was pulled out. The trucker lady pointed at the aide and said, " She brushed against me and her goddamn TITS ripped my IV out! You oughta get those things licensed as lethal weapons!" I thought the aide was going to 1. die of embarrassment 2. wet herself. (always a distinct possibility, as I overheard a rumor she actually does wear Depends just today.. well poise pads, but still.) The only person laughing harder than the rest of us was the poor man who was pushing the stretcher. Every time I saw him for the rest of the day he just kept on shaking his head and laughing every time he glanced in my direction.

Why Three Peaches?

I think most people are born with a sixth sense about things. Things happen, occasionally our instincts are wrong, and eventually we stop listening to that inner voice. I, however, am stubborn. And when I am right, I am RIGHT. If I'm unsure about something; however, I am the first to admit it. This past Sunday morning I knew something bad was going to happen on my way into work. I have a tendency to internalize a lot of what goes on around me so I think that God gave me that extra sense in order to prepare me for the big things in life. So on my way in to work I turned up the music and let the sun warm my face through the car windows and said to myself "whatever happens, happens. I can handle whatever comes into my path. I am READY."

In report, I get the details of a patient who's been vomiting for the past few hours. He has several cardiac blockages, has a history of non q wave MIs (heart attacks that don't show up on EKGs in a typical manner). He received Zofran at 0600 and he's been vomiting frequently ever since. The night nurse told me she paged a resident and the resident told her they don't want to change anything medically at this time. So he continues to vomit without explanation, he continues to suffer with no relief. UNACCEPTABLE. His was the first room I stopped into and upon seeing him I decided right then and there I was, in no uncertain terms, leaving him until he felt some relief. I never saw someone so violently sick after having Zofran, my gut told me something was just not right. I page the resident and explained I knew they told the other nurse they didn't want to change anything medically but it's 0715 and he's still very ill and needs to be seen. Resident orders compazine (another IV anti emetic) and then it's just a matter of waiting for pharmacy to get the med into my desperate hands. Throughout all of this I am sitting next to the patient, asking questions, reassuring him..at this point he says, "I'm in congestive heart failure, please get me help!" I grab the resident and she comes in and listens to his lungs and hears the same bilateral crackles I told her about and she turns and turns off his IV fluids and says, "he's a little overloaded, he will be fine". If WTF had a facial expression, surely I had it right then and there. Then she said, "Well what else do you want me to do?"
REALLY?
Well, SHIT. All I have to do is turn off the IV when someone is having a heart attack? Someone call the American Heart Association and tell them they are ALL CRAZY for all that CPR bullshit.

So I called a Rapid response. I went right over that apathetic bitch's head and guess what? By the time they got into the room he was completely unresponsive.. but he still had a heartbeat, god damnit. His O2 sats were crashing. Respiratory put him on an O2 rebreather mask. Sats still dropping. His lungs were filling with fluid. I pushed 80mg of lasix, the CCU nurse inserted a foley. His extremities were mottled..I pushed 1 mg of morphine then another mg of morphine. Respiratory intubated him. His eyes were glassy and fixed on me. The tube keeping him alive held in place with what appears to be a gag. The man I was conversing with and comforting 10 short minutes ago would surely have been dead at this very moment had I not gotten him the help he so desperately needed. He was on his way to the critical care unit. Away from me.:( Why did I feel like I failed him? When I brought this question to my boss she asked me simply, "Did he code? Did his heart at any point actually stop?" The answers were no and no. She told me I got him help before he coded. I prevented a code- I did not fail him at all.. I helped keep him alive.

After he was gone, I was gathering his belongings to send downstairs to him. Dentures (I added an efferdent tablet.) A watch, some nice pens, clothing, and three peaches. Logically, I knew he wouldn't be eating them. I probably should have thrown them away..why was I even worrying about these peaches?? But what if his family wanted them? What if tomorrow morning he's extubated and feeling really hungry for a peach? Throwing away those 3 peaches meant I was giving up hope for him and I wasn't ready to do that. Personal belongings list, item #5? 3 peaches. You bet your ass.