Thursday, November 22, 2012

Beauty Salon

When I worked in the ICU, I worked nights. Normally, it's as busy as days - emergencies come up, dementia patients become disoriented, critical patients mysteriously have perfect timing to start crashing.

This particular night, it was the "q" word. We learn never to speak it's name. The place wasn't full of patients.  I had 1 stable patient and the other was iffy. The iffy patient never had family visits. I went into her room to assess and spend some time with her. She had dementia, but tonight she seemed incredibly lucid.

I peeked in on my other patient, stable and sleeping. The other nurses were reading books and playing on the computer. It was a "q" night.
I went back into my patient's room and sat down to talk with her. It looked like she hasn't been bathed in a long time, she smelled bad and was completely disheveled. Personally, I can't stand that. Wherever she came from, they weren't doing a very good job of taking care of her. You can just tell by her hygiene.

I ran around getting all of my items to clean her up. I spent over an hour in her room washing her hair, doing mouth care (which I absolutely hate doing because it's one of my weaknesses - oral care. It can be disturbingly gross.), bathing, changing her gown and bedding. I had a nurse come in and check on me because I had been gone so long.

Once I was done, she looked good. She actually didn't look as sick as she was. We talked about her life and she told me some interesting stories about her past. I joked that she looked so good right now, we should go have a night on the town. She agreed and said when she felt better, she wants me to drive her to a place where she can sing again. I told her I'd be back on shift in 2 days and I would see what we could do about singing. She was happy and thanked me for a nice night. She fell fast asleep.

When I returned to the ICU two days later, I didn't see her. Her room had another patient in it. I asked the day nurse during handoff report where was Mrs. So and so?
"Oh, she died yesterday morning."
She died a few hours after our beauty salon night.
I was sad, but I felt comforted knowing that her last night on this earth was a good one. I was happy that we had that time together.

Tuesday, November 20, 2012


I already had a good rapport with a stable patient who had a previous stroke and experienced expressive aphasia as a deficit. (For the non medical people: it means the patient understands language, but cannot speak the words that he/she means to say.)

I popped my head into his room because I wanted to check on him quickly. I had some situations arise and I knew I would not be back for a while. I guess some other family members arrived while I was out of the room.
"Hi Mr. Soandso. Are you feeling any better after the medicine I gave you?"
He shook his head for yes.
I proceeded to tell him I would check on him later and that is he needed anything, all he had to was call. I was pretty much in a rush, so I started to head out the door.

The one family member there jumped up and stated, "He can't talk. He had a stroke."

"Yes, I already am aware of that. We've been communicating though." And I left the room, jotted some notes on his chart.

The woman approached me in the hallway. "What's your name?" I told her. "You were really defensive when I told you about how he couldn't talk. And you kept talking to him."

What I said: "Well, I'm sorry if you thought that. My intention was not to appear defensive."

What I wanted to say:

Ma'am, stop wasting my time right now with your petty hurt feelings. I don't have time for this. What you misconstrued as defensive was me trying to juggle 40 balls at one time - if I didn't even pop my head in there for a minute, he wouldn't have seen me for hours. Yes, I'm going to talk to him. I know he can't speak in complete sentences, but he understands. I talk to many patients that I don't know if they are mentally there - people in comas, post resuscitations, etc. It's called respect.

I just got done telling a mother that her child's symptom is cancer. She's in complete shock and is dealing with the horrible news by lashing out at her nurse. I don't enjoy it, but ya know something - she has an excuse.
In the other room, I have a patient that coded an hour ago and died. I have yet to talk to the family. I went into the room and saw that no one helped me out by cleaning up the body a bit. It was a very messy death. How can I let the spouse go in and see his loved one like that? I had to clean her up quite a bit and set up the room so her spouse can say goodbye.
As I running about for those patients, I had to check that the kid with a bleeding wound had enough gauze and pressure so his bleeding was controlled.

So, your delicate temperament is really, really low on my priority list.
Oh, and since you're giving me grief, I'm enforcing the one visitor policy rule - please head to the lobby.