Ho Hey

I. Am. Totally. Completely. Madly. in. Love. With. this. SONG.


Repeatrepeatrepeatrepeat. LOVE IT. Can we say just adorable!

Vegetables at Home

The other night at work, I was taking care of an elderly man in his 80s. Like it so often happens, I often end up having heartfelt conversations with patients around 3-4 AM. Some people may think that just because I work nightshift, I never see my patients, because they sleep the whole time. Not true. They sleep 25% of the time, lol. In reality, I spend a lot of time with them before they go to bed, from when I come on at 7pm to 11pm (about). I get to put them to bed, which can be quite a personal thing- I am involved in their routine on a nightly basis. Then, once they go to bed, I see the average patient even 3-4 times after that. Either they need pain medication, need...anything, they need their vitals attended to because they are out of whack, or they need assistance to the bathroom.

So this patient was having a lot of gastrointestinal problems, so I was in with him a lot helping him to the bathroom. After one of his trips, he was feeling sentimental and we got to talking. He got to telling me his life profession, about his wife whom he's still happily married to, his friends, what he does per daily basis in his retirement. He was telling me how upset he was that he's never been sick his entire life, and then now in his retirement- the time he's always envisioned being able to enjoy- he's sick now. But then he got to telling me something, something that he probably didn't even realize made me think so much.

I've heard this a lot from patients, especially my elderly crew. They are worried more about their home life, more so than the fact that they are sick at the moment and in the hospital. They are usually worried about their dog, cat, etc., or worried about their spouse, or the mail, etc. But for some reason, this guys stressor made me so sad.

He was so worried about his vegetables. He was telling me he has been working on a full garden at home for years now, and how his wife was now alone at home. He said she wouldn't be able to drive his truck down to the garden and pick his vegetables, and they would go to waste- Even though she told him she would try. He didn't even want her to try, because he didn't want her to hurt herself.

Now you may think, why is this such a big deal? But the look on his face, the sorrow....he was so incredibly upset, to the point of almost tears, as he said "those tomatoes were just about grown too, they were going to be perfect....and now I'm in here. You know, I try to feed all my friends? Some of my neighbors and friends, I give them my vegetables because I have so many, and they are so poor that they rely on my garden. And now I'm here and can't be in my garden."

These kinds of things are hard for me to hear because as a nurse, I can't help them on these problems, whats making them so sad. I can treat pain, I can treat upset stomachs, I can treat mental conditions, I can treat infections, I can treat electrolyte imbalances, I can treat chemotherapy side effects, etc. But I can't go to my patients home and pick their vegetables or feed their pet, or make sure their spouse is OK. It breaks my heart. I am the type of personality where I want to fix everything, not just in nursing. When I'm in a relationship, I want to make that person completely happy. I can't  stand for my boyfriend to ever be upset- I do everything possible to turn the frown upside down, if I can't help it. And it kills me if I am ever the cause of someone else's sorrow.

I had a patient tell me a story a couple of weeks ago. There was a time where my patient that I was taking care of at that moment, her husband was in a nursing home while she was still at home, by herself. I guess conditions warranted that either family wasn't close by, didn't care, or family didn't exist, so it was the two of them. Well she went and visited her husband every day in the nursing home. Well one day she didn't come visit. The husband knew something was wrong, he told a nurse. The nurse shrugged it off, figured he was getting confused or the wife was just busy at home that day. The next day, she didn't come again, he told another nurse. She did the same thing. He began telling some of the other residents, and they backed him up- telling the nurses that the wife does exist and she hadn't been there in a couple of days. Eventually, one nurse decided to go above and beyond her call of duty. She remembered seeing the wife at one point. She found the patients home phone number and called the house, there was no answer. She called again later in the day and there was still no answer. She decided to call the police, and asked if they could please go check it out. Turns out they found the wife in the basement on the floor, she had went to get something and tripped. She was alive but had spent 3 days on the basement floor with a broken hip...Obviously the police saved her and sent her to the hospital, but ultimately, that nurse saved her. That nurse went above and beyond her call of duty to help her patient, the husband that she was taking care of. She saw the whole holistic picture, what was making him so upset. She fixed it and I think that's amazing.

So my patient was that wife, a couple years later and she was telling me that story. She told me how she survived by crawling to where she knew she had saved food down there, and fought through the pain, and some other....unpleasant survival techniques- being that humans have body systems that need to be relieved. It was so sad, but inspiring.


Well that's it for today folks. To all my other nurses, just remember- there will be things you can't fix sometimes. But what you can do is be there to listen. Sometimes that's all that your patient needs. So often does the nurse treat the body system that needs attention, and then they leave. Sometimes we have to leave because another patient is critically ill....but other times....not so much. Just always remember the psychosocial aspect of your care plans. See the whole picture. It will make you so much better of a nurse...



- A Writer in a Nurse's Body



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Well Alrighty Then

So I had this very elderly lady last night. She was having some difficulty urinating, but yet wasn't showing much on the bladder scanner and didn't give out much when we straight cath'd her (put in a very temporary catheter just to extract urine). She then felt it necessary to also remember she hasn't had a bowel movement in a week. Problem solved. Sometimes if you're anatomy is slightly strange and you're constipated and you're laying in bed a lot, your bowels can sort of impinge on your bladder, to make it easy. So new goal was to get her to poop. I knew I wasn't going to accomplish much medication wise with a closed pharmacy at 400 AM and an attending doctor that most definitely wouldn't want to be woken up at 400 AM with a request for a laxative.

So I decided to go with the good ol' fashioned.......prune juice! YAY!

I've heard the old age tale that it works best when you heat it up first. But It was 4 am and my brain wasn't working at full capacity, and when I was staring at the microwave and staring at my choice of cups, my brain couldn't remember which ones were OK to put in the microwave so I just decided to give it to her cold and call it a day.

So down goes the prune juice.

About an hour later, she presses the call bell. This is our conversation:


Patient:  "That prune juice you gave me...."

Me: ".....Yeah?"

Patient:  " It was cold."

Me:  "Oh. Yeah. I'm sorry."  *makes weird face*

Patient: "My husband heats it up at home and always gives it to me that way."

Me: "Oh...well next time we can heat it up for you."

Patient: "Actually,  I've always hated it warmed but never had the heart to tell him because he was sweet enough to make it."

Me: "Oh.......so you liked the cold prune juice?"

Patient: "Yeah."

Me: "Okay........"

*Awkward moment*


Me: "Um, is that all you had to tell me?"

Patient: Yep.




As I was charting a little bit later into day shift outside her room, I overheard her telling the day nurse how glorious the prune juice was and I had to work really hard at stifling my laughter in the hallway. Thank you to the confusing microwave!  o_O Win!


~ Another special nursing moment from WNB



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Just Answer the Question

These can be the most aggravating types of assessments:

Me: "have you ever had an ulcer before?"

Patient: "well my grandmother did, on my maternal side. She died from that ulcer, then my uncles step-son lives near her in Alaska and had to take care of her cat because it had no where else to go and then that cat turned out to have diabetes and my brother had to give it insulin- you know what insulin is, right?- and then the cat ate this flower once so then my uncle couldn't buy flowers anymore."

"okay. But have you ever had an ulcer?"

Patient: "oh uh, no. My stomach is great. My friends aunt had stomach cancer though."


-_____-


Very nice people indeed, but when I have 110 questions to ask when admitting someone and they answer every question with a story that always circles back to a friend/aunt/uncle or CAT, you kind of just want to stick yourself with 100 units of insulin and call it a day.



Am I already jaded??!


:/

WNB



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A Satan kind of Business

Yesterday I went to a hospital-sponsored "Birthday" breakfast, where employees get to sit at a breakfast table with the hospital CEO/CFO and some other important big-wigs. I have been employed at this hospital for what will be 6 years this August, and this is the first birthday that I've actually went.

We just hired a new CEO, and there have been mixed feelings about him. Normal, I suppose,when a new big wig comes to play, as this instantly makes people fear they will lose their job. A CEO has to really work in order to gain the trust from its employees.

So I wasn't sure what to expect from this "birthday breakfast" with the CEO....how many people would go? Would it be 1:1 time with the CEO? What would we talk about? Cupcakes? Breakfast? The weather? Monkeys? History? Rules? Africa? Eggs? Pancakes? Opinions?

We started off the breakfast with one of those "icebreakers" where we all had to share our name, how long we've been employed, what we do.....squishsquash like that.

Then we got into the real mishmosh, the nittygritty of things we've been wanting to hear about. When are we getting our raises back? Whats going to happen to the hospital? Are we going to remodel? Are our jobs secure? Everyone sits tensely in their seats, politely yet rebellious as a lion inside, ready to pounce, yet trying to behave. People get very tense when it comes to money and their jobs.


Lately our hospital census has been in the toilet, meaning we have not very many patients. This raises a lot of concern, being that without enough patients , we won't have enough money to sustain the business or pay our employees. So everyone has been nervous, so of course this issue was brought up with the CEO. His response is what really got me thinking.

He jokingly said, "I guess we gave out too many flu shots this year." People laughed quietly.


But what he said.....it's absolutely true, and yet it isn't true. True, we did give out a lot and they were effective. But we didn't give out "too many". We prevented a lot of people from getting sick this year, and it may have impacted our census, maybe it didn't.

But it got me thinking....running a hospital is like running a Satan business. We thrive, we depend on people getting sick or injured. When less people get sick or injured, our business suffers. We market our business just like any other type of business out there- We billboard and advertise on TV to get people to think of and choose us when they are sick or injured and need to choose an ER.

I guess the point I'm trying to make here is that, an ideal world would be if a hospital could support itself and its employees without depending on others suffering. It can't happen, I suppose, considering money doesn't just magically appear and fund organizations.

In my schooling, we learned about the growing concept that hospital patients were changing. In this present day and in the coming future, a typical hospital patient is a lot sicker than in the past. More and more illnesses and conditions are treated in the outpatient, long term care, clinic or home care setting. This is great for public health care but it could be why we are seeing a lower census as of late. Some of these sicker, long term hospital required care patients don't have insurance or insurance that is going to pay. Also, these patients aren't turning over the beds and are taking up space, draining the staff, etc. So its like the hospital administrations depend on the misfortune of the community to sustain itself, but we need you to get better quickly, so you can be a patient of ours, pay us and then leave so we can give your bed to the next paying patient.  Like I said, its a Satan Kind of Business....


It's similar to the concept of warfare health care. Back in the days of surviving WWI and WWII, we learned and advanced so much in health care because of all the emergent practice we had on suffering soldiers. Suddenly we had patients that were going to die anyway if we didn't try something, so it gave surgeons and doctors of the age to experiment and practice....and sometimes save lives resultingly, sometimes not. But it taught and revolutionized health care. It's the concept of trial and error.  It's yet another example of how health care thrives off the mass suffering off its population.

Yet this concept turns on itself. The more people that suffer and come in to the hospital, the more money the hospital makes. For non-profit organizations, such as mine- this allows us to then put the money back into the hospital, better machines, more nurses, better doctors, new units, more services, which all lead to safer, and better patient outcomes and satisfaction, which then leads to word of mouth in the community to others, which therefore leads to more money back into the hospital from others that are suffering. It's a cycle. A Satan cycle. A necessary cycle in the health care industry. A sad cycle.


I've had this post, this thought, stemming in my head for a long time, since June. I even had half of it written out but decided to halt the writing on it because I felt it was getting too political. I really know nothing about politics or finances. Nothing. I know that. All I know is nursing, nothing administration. All I know is what nurses see and how nurses are affected. So what prompted me to finally go through with this post? My unit, the smallest unit in the hospital, recently shut down last Friday along with the second smallest unit. At first we all thought it would just be the weekend. Tomorrow we will hit one week. All of us are on our toes. This is where a low hospital census hits home. My entire staff team is now orphaned, being sent out around the whole hospital, floated. It's miserable. We all want to be back on the unit we were hired too, the unit we have raised and grown to love throughout the past year.

The only, and I mean only, good thing about this sad misfortune, is that I am at least gaining experience on other units in my hospital. But I miss the familiarity.



Thats all for now folks,

~WNB.




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