The last laugh

I love when I get the chance to have the last laugh... and I owe it all to an aware Pharmacist at Local Pharmacy.

My night shift started off with a patient and her husband who were very upset, to say the least, that the patient was not discharged from the hospital. The discharge was being held up waiting for a doctor to come up and assess the patient to make sure she was safe and ready to be discharged. I mean... the patient was post brain surgery. But that was not of the concern of the patient or the patient's husband.

Long story short... the patient was yelling (although she claimed that we gave her the worst headache of her life), the husband was yelling. In fact the husband was literally in my face screaming, spitting, and turning red. Security was called. It was great... it's what I get up in the morning for (read with sneering sarcasm).

The patient is demanding her IV Dilaudid because her oral Percocet was not working. But she wanted to go home immediately. I'm still not sure where she thought she was going to get IV Dilaudid at home from... but I can make a good guess.

Finally we get the patient discharged, scripts in hand. Goodbye and good riddance.

About 3 hours later we get a call from the Local Pharmacy who wants to verify some scripts that we had discharged a patient with earlier in the day. Surprise... it was the very same patient who made my life so fun just a few hours earlier. The pharmacist was concerned that the narcotic prescription had been altered.

First... you treat the very nurses, who cared for your sorry ass after you just had your BRAIN cut into, like pond scum. Second... your husband comes close to what could be considered assault on a human being, aside from the fact that assault on a health care worker is a felony. Third... you threaten a law suit to anyone who dared look in your direction. And lastly... you ALTER your narcotic prescription??? And then you try to pass it off?? And now you want ME to verify the script... ME? (Do you remember what you said to me? Do you remember what you called me? Do you remember that your husband covered me in his saliva? You are lucky that I'd rather make sure your got your meds than risk you coming back to the hospital!)

Prescription did indeed appear altered.

So now you have NO pain medication. You likely got the cops called on you if you treated the pharmacist the same way you treated me. AND... I got the last laugh!

Uhhh... ya think??

So over the weekend I saw a patient that was admitted to the hospital because she had stabbed herself in her side with a pocket knife. The pocket knife was probably no longer than 2 to 3 inches, but regardless... it is a knife and it doesn't belong in any part of your body.

I decided to get a little more background on the patient, so I read the EMS report... which is ALWAYS a fun sport. The patient, herself, called 911 for help. Not a bad idea if you just stuck a knife in your side... but I want to know WHY she did such a thing. When the EMTs arrived on the scene they found the patient in the shower, wet, naked, and holding a towel over her stab wound to control the bleeding. WTF?? She called 911 and then got in the shower? She told the EMS crew that she wanted to make sure she was clean when they got there. Hmmm... I'm starting to see a pattern of bright ideas forming. So then the EMS crew loads her up into the ambulance to bring her straight to where I work... damn it.

So along the way to the hospital, which I'm sure included passing by other hospitals (lucky bastards), they ask the patient some background information and the question of all times... WHY? The patients pertinent background information includes that she has been doing meth for 2 days. Ahhh... clue number 1. It also included that she had drank 2 cases of beer and a fifth of vodka. Clue number 2... but I STILL don't understand why. So the EMS crew finally ask her if she was trying to commit suicide. The patient said "No, I would say it was just poor judgment."

UHHH... YA THINK? DO YOU REALLY THINK?? STABBING YOURSELF IN THE SIDE IS JUST POOR JUDGMENT??

A little lotion...

This is an old story from my days of nursing school... and one of my more embarrassing.

I was doing my rotation through couplet care... mom and baby area. Nothing I have ANY interest in whatsoever. I'm happy for them... it's great... blah, blah, blah. I like the blood and guts.

Of course, by this point in time I had no introduction to 'incontinence cream.' Also known as barrier cream, baza cream, ect. It's basically a very thick waterproof cream that we use to create a barrier between a patients skin and the bed that they will eventually wet. Wet bedding against skin is a recipe for disaster. So while we check and change beds often, it is still best to protect the patients skin from the moisture all together.

So here I was, this silly little nursing school student in her white pants and university scrub top, wandering around in couplet care looking for an IV to start or something/ anything to make the shift a little more productive for me. (As bottle feeding an infant really didn't interest me!) I washed my hands for the 954,736 time that day and my skin felt like it was about to peel off so I decided to look for some lotion to soothe the sandpaper that my hands were. I found this white tube of cream. Looked like lotion. It said Johnson & Johnson on it... so I squeeze out a large pile of this cream into my hand. I'm excited that I found this thick cream... I'm thinking it will take care of my hands for sure.

So I start rubbing the lotion all over my hands... WTF. My hands are WHITE and WATER-PROOF. I run to the sink and attempt unsuccessfully wash this stuff off before anyone catches me. This is NOT what I had in mind when I was looking for something productive to do! It took forever to get most of the damn cream off... I went home that afternoon with white still under my fingernails (I was trying to literally scratch the stuff off my hands under the scalding hot water), white around my cuticles, and white in the deep grooves of my hands.

I started carrying around a small tube of lotion in my scrubs.

I work in a zoo

I've decided that I work in a zoo.

In the dead of night, when all the day-shift workers are at home in bed dreaming about how all the night-shift workers are sitting around watching their patients sleep, the nursing unit takes on the feel of a zoo.

The little old confused ladies are screeching nonsensical words or calling out a name repetitively. The confused old men are yelling obscenities. The unfortunate patient that we had to restrain to the bed is writhing around in the bed and trying to chew his way out. The patient off his psych meds is jumping up and down on his bed. Some patient is smoking in the bathroom. IV pumps are beeping. Cardiac monitors are alarming. Bed alarms are blaring. Phones are ringing. A family member wants us to order them dinner. The alert patient is yelling because it's so noisy and it sounds like someone is having a party. And somewhere there is a patient taking off his hospital gown, removing his IV, and taking down his surgical dressing. (I've even seen a patient chew off his splint!)

The nurses are running around like they are in the midst of a prison riot.

I just feel like I'm in a zoo. I'm just waiting for the day when I have to tell a patient that they shouldn't be swinging from the ceiling.

No medical history? At all?

Don't tell me you do not have any medical history if you follow that sentence with your list of allergies. People don't find out that they are allergic to Depakote, Haldol, Geodon, and Lithium by just sheer luck.

And when you were born no one handed you a list of Morphine, Tylenol, Toradol, and Fentanyl as your allergies and recommend that you just request Dilaudid or Demerol when you need pain medication either.

Either that or I must have lost my list... damn it.

Must be bored...

I see this often and have yet been able to figure it out.

A patient will come into the hospital with a valid complaint. They do not appear to be looking for drugs (i.e. pain medication), cause lord knows we get that all the time. So we admit this patient with the valid complaint and begin the workup and consultations to specialists. Different studies are ordered and different medications are started. But here is what gets me... the patient refuses to go to the study/ exam (say an MRI). The patient refuses to take the medication. The patient refuses to have their blood drawn. The patient yells at the nurse whenever they enter the room or try to take a blood pressure. The patient complains endlessly about their original complaint.

Why do you come to the hospital at all if you don't want our care???

Guess what... you don't have to go to your study, take your medication, have your blood drawn, or have a nurse come into your room IF YOU STAY AT HOME.

Complain to your damn cat... they will take care of you the way you plan on letting us take care of you.

When do you call it quits...

We got a male patient in his 70's today that came in covered in what looked like scratches... lots of them. Some deeper than others, many had drawn blood at some point. He was COVERED... head to toe in them. Nicks, cuts, scratches, bruises... he even had what appeared to be rug burn to his butt.

The patient is awake and with the program so we wonder what could be going on here, is it abuse or neglect? So we question the patient, who is extremely hard of hearing mind you, and he tells us his story (and the rest of the hospital with his volume level).

Him and his wife got in a fight yesterday and apparently it was an all out brawl. And I mean a serious, rolling on the floor, scratching, kicking, punching, dragging across the floor kind of fight. In your 70's? With all his injuries you'd have to wonder about the stamina in these two pistols.

Well, wife (also in her 70's) looked much the same. And the police were indeed called to the house during the "event." I don't think I want tickets to that event... I'll pass. But I do want that kind of energy when I get to their age. Who wouldn't like to be able to kick someone else's butt and live to tell the story (without a broken hip) at that age??

But seriously... when do you just call it quits.