My little lady patient was about 93 lbs-- and 93 years old. Tiny little thing, and cute as hell. She was very pleasantly confused and ate like nobody's business. When I got report the offgoing RN told me "I made her toast with jelly and coffee, she was wide awake at 5 am complaining about how no one feeds her in this place!"
it was 7:05am when I walked into her room and she said, "When is breakfast, I'm starving!!" I reminded her she had some toast already but "if she wants, I can call for her real breakfast". Called for her, peeked in her chart and see Dr. progress notes "failure to thrive", "BMI 17.2", "decreased appetite" hmmm.. something is not jiving. This woman appears to eat very well while here, so not a typical failure to thrive case at all. Also, she had a non healing lower leg ulcer, so the Drs were thinking i wasn't healing because she wasn't eating enough (plus her BMI is low).
I scroll though charted Is and Os.. every meal for 4 days 100% eaten. Interesting.
I talked to her and asked her what she eats at home. (she lives with her son) Then she told me all about how money is tight, she doesn't get a lot to eat at home, etc. etc. (And I think, "I have seen this before." ) A little while later the son came in. I spoke with him for a bit about her wound culture that's positive for MRSA and what is means for him. (frequent handwashing, wearing a protective gown, etc etc) I gave him educational materials on it, too. He was very freaked out by the MRSA, it took a lot to calm him down about it. Then I stressed the importance of nutrition for her wounds to heal. He said he understood and that money is very tight and it's hard to pay for her medicine and food. (he was very thin too) At that point I asked case management to provide a list of resources to him to help him pay for food and medicine. So many people deal with those very issues, it is heartbreaking. Worse still, you practically require a degree just to figure out how to navigate the systems just to apply for assistance. Every organization has their own way of doing things.. totally frickin nuts. And frustrating.
Anyway, a little while later, my little lady asked me when I was going to have lunch. I said oh in a little bit. And she said, "will you come in here and eat with me? It's so lonely here eating all by myself.." awwww!! I really really wish I could have had lunch in her room with her, she asked SO sweetly.. but can you just IMAGINE if an infectious disease doc had happened by and saw THAT?? Or the State Dept of Health??? lol I told her I would do my computer work in there with her and keep her company while she ate, though. So THEN didn't she take a bite out of her grilled cheese and start saying "have a bite! It's really good! I want you to have some!" and began trying to shove it in my face.. okay.. here's the thing.. I wouldn't take a bite out of a sandwich my own husband or children took a bite out of.. and here's this (albeit adorable) woman with MRSA asking me to take a bite. OH HAIL NO! LOL!! She was way cute, though and I felt badly turning her down, but even I have my limits. haha!!
Then the little peanut started talking about her infection "I don't know where I might have picked it up. I don't go much of anywhere and I don't even use public hoppers!" (hopper=toilets in case you didn't know) So I explained "germs are everywhere, even the grocery store. As we get older it's just easier for us to get sick from them.." I thought I explained it pretty well but she was hard of hearing and confused so everyone up and down the hall and everyone in the physician charting area heard me yelling, "Germs aren't always from the hopper! You can get them from touching a grocery cart handle or even from touching the mailbox!!" I must have said the same thing about 10 different ways and each time I got louder and louder.
She answered with, "When are you gonna eat? You've been in here for 45 minutes! No wonder you're so skinny!" I asked her if she's sick of me yet? And she said "YES! Eat your lunch!" and got a devilish little grin.
I removed my contact precaution gown, then my gloves and rolled them up and put them into the garbage and proceeded to step outside the room and announce to fellow employees and family members of neighboring rooms alike within earshot, "I am going to have some lunch. Then I am going to use THE HOPPER."
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