My most dangerous and hilarious patient encounter EVER

Back when I was still a nurse's aide in 2009, I was assigned to do a one to one watch on a prisoner. In case you aren't familiar with how it works, hospitals use their nurse's aides to sit in rooms with people who are in danger of hurting themselves or others. If the patients are dangerous, they are put into 4 point locked restraints in addition to the one to one watch.

On this day in particular, I had a prisoner with a prison security guard with him.  Since the security guard was not hospital staff, they still needed me there.  The prison guard had the VERY IMPORTANT job of reading the paper and ignoring the prisoner while I sat arm's length away from the prisoner and getting cursed at and threatened.  The prisoner also had a penchant for spitting, hence the spit shield (an over the face hood made of black netting).  The prisoner was not only inappropriate and verbally abusive, he was also a bit out of it.  Because of this, he kept asking why my panties were over his face. :/

So, dinner arrives and I am informed by the nurse that I have to feed this guy because if we untie his hands he will try to escape.  I am not happy about this because that means I have to raise his spit shield and very likely be spat upon.  AWESOME. Before I decide to raise the shield, I figured I better be sure the guy was actually.. I don't know.. hungry.  So I look him in the eye and say, (very sweetly I might add), "Are you hungry?" He looks directly into my eyes and says in a gruff, muppetlike voice "Yeah, I'm hungry.. HUNGRY FOR YOUR PUSSY!"
:/

The prison guard heard it and I could tell was about to call him a piece of shit or something and I held up my hand to the guard as if to say "just hold on.. don't say anything".  At that point I removed the lid from his tray, slammed the lid down on his bedside table and said, "WELL YOU ARE GETTING SPAGHETTI AND MEATBALLS." Prisoner's demeanor immediately changed to defeat looked down at the tray and opened his mouth for me to feed him and proceeded to obediently eat his meal with no obscenities or spitting. Then he let me brush his teeth after. (his breath was TERRIBLE). The prison guard could not have looked more proud of me. ;)

P.S.  This is what a spit shield looks like. (and for the record, my panties NOWHERE NEAR that size)

Screw this housework noise

I'm SO getting a maid.  Then you know what I'm doing? Hiring a personal trainer.(apparently, if you are a woman you get quite the discount if it's a gym frequented by men) Then my husband will be all "omg, what a great workout housework is!" Then I will hand him a mop and a vacuum and say, "You're looking a little soft. There you go, Mr. Universe!"  Then I can fire the maid.

Truckers and Angels

TJ was a trucker from Michigan, just passing though our little part of PA.  He had just docked his rig and was behind a rather large mound of dirt.  As he made his way around his cab he felt.. something.. sudden shortness of breath, chest pain.. then a sudden definite sense that he was about to die. He gathered what breath he could and let out a cry for help-- knowing full well that from behind that mound of dirt, what little bit of yelling he could do was likely to be muffled. He yelled anyway.

And someone heard him.

He was rushed to my hospital (which happened to be just a block away from where he was). He went to the emergency dept where he lost consciousness within minutes of arrival. He was in congestive heart failure and cardiogenic shock.  He was intubated in the ER and was sent to the medical ICU unit for a week while he stabilized.  His wife was contacted and she tearfully drove straight through non stop from Michigan to be by his side. She sat with him while he was completely knocked out being kept alive by a machine.  Another family in the ICU heard about their plight and paid for her to stay in a local hotel for a week.(Later, the hospital put her up in a special house they use for situations exactly like they were in)  Once TJ was stable they found he had severe aortic stenosis and aortic insufficiency-- he needed a new aortic valve.  So off to surgery he went.

Once TJ was in the OR, in the middle of the surgery, his aorta suddenly dissected.. The surgeons and nurses furiously worked to transfuse blood as TJ slipped further and further away.. after countless units of blood, an emergent Bentall procedure was performed.  TJ lived through the surgery. He lived through the night. And after 4 days in the Cardiac Surgical ICU?  He was all mine.

TJ had two mediastinal and 2 pleural chest tubes protruding from him, indwelling foley catheter, external epicardial pacing wires (capped), in insulin gtt set ay 4 mLs an hour (2 units/hour), a midsternal incision with an acticoat dressing over it, IV venofer running, 4L of O2 via nasal cannula and a humble, scared look on his unshaven/been through war of a face.

I helped him out of his wheelchair and into his recliner.  I frequently checked on him, I ambulated him around in the hallways, I taught both he and his wife about different meds and side effects of them... and he told me his story.

So last night I was saying goodbye to him and I will never forget the things he said to me. He said, "I was never an overly religious man.. but I truly believe it was no accident that I was right around the corner from one of the best cardiac teams on the east coast when my heart gave out. God had one hand on my shoulder and one hand on that surgeon's shoulder when he was operating on me.  The kindness shown to my wife by you people is just as appreciated as the top notch medical treatment you have given to me. I don't really know how to thank any of you enough for all you have done and continue to do.."  and with that, the Grizzly Bear of a trucker wiped huge tears from his kind, blue eyes and I gave him a big hug and I thanked him by telling him, "It's patients like you that make this job the best job in the world, so on behalf of everyone here, thank YOU for allowing us to care for you."

TJ's birthday is coming up on Sunday... his goal is to be home by then.  Something tells me, he's going to make that goal.  I don't think his angels would let him miss it. ;)

PAPER IS MAGICAL

Have a problem with your business?

Add a form!

Patients falling on the floor too often?

Hang a sign on their door!

Too many loose ends in your office's workflow?

Give everyone a checklist!

Let's get down to brass tacks.  Sometimes, circumstances in a workplace change.. sometimes for the better; but more likely than not, for the worse.  Is it REALLY necessary to insult the intelligence of your staff by even hinting that a piece of paper is going to fix an increase in falls?  Dude.. we've got fuckin stroked out (may as well be tripped out) people flinging themselves out of bed all the frigging time.  Do you really think a SIGN is going to help the staff??  How about.. oh I don't know.. STAFFING THE FLOOR PROPERLY?

Hey!! Wanna see my new shirt? It says "ARRRRR" on top and "ENNNNN" on the bottom.

(second half of this message is for the person who told me to lighten up on my blog)  I don't know though, these girls are pretty heavy, not sure how much lightening up they are going to do. *shrug*

A Discussion at the Nurse's Station

A new aide was orienting and she was talking to one of the nurses about getting attached to patients.  The nurse said she doesn't remember much about any patients and that she never got that close to any of them. Then the aide turned to me and said "what about you?"

oy.

I told her I remember most of my patients pretty well and if they died I always look up their obits after so I can learn about them as a person and that I hate knowing people just as "sick".  What I didn't tell her is that I blog about every one of my notable patients, and that I save obit pics on my hard drive so I never forget the faces of my patients who have died.

If the FBI ever looks at my hard drive I hope they also see this blog explaining why I have their pics on it.  Otherwise I'm going to have a lot of splainin' to do.

Like a sheep being lead to slaughter

Not really looking forward to my 3p-3a shift today.

A rare Saturday night post with sad news :(

The four point locked restraint stroke patient died on Wednesday.

That crooked smile of his will forever be etched in my mind.  I'm glad I brought him a little joy before he passed away. He probably had a long road of tube feeds and permanent paralysis ahead of him so in a way God was merciful in letting him go.. and his family was there with him when he passed, so there is that, too...

Rest well, my friend.  I'm sorry we had to restrain you like that, I hope you understand better now why we had to do it.