Nursing

Bring Him on In, Honey!

At the end of a long, long day on my dialysis unit, there were only two of us to finish up the work of cleaning up and setting up for the next day’s treatments.  There was still an elderly gentleman to be returned to his room.  I helped him into his chair, wrapped him in a blanket, and headed back to his room.  As always, I was in a bit of a hurry to get home to my children.  I wheeled him into what I thought was his room only to find the bed already occupied by a little old lady.  “Oh excuse me Ma’am.  Wrong room!” I apologized.

“Just bring him right on in, Honey.  I’ve been here quite a while!”  We all got a good laugh out of that.

 

Hint for anyone in hospital.  Always ask that your wheelchair seat be covered and be wrapped in a blanket when you leave your room.  Wheel chair seats can be soiled and those halls get cold.

If I can ever do that!

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Cartoon on courtesy of all nurses.com

After suffering through numerous brutal experiences at the hands of nurses as a student, I swore I’d do my best to encourage nursing students and ease their path.  I took time to show them procedures and include them at every possible intervention.

I invited an eager nursing student to join me as I prepared to insert needles into a patient’s dialysis access prior to a treatment after getting the patient’s approval.  Dialysis patients were almost invariably willing to help teach.  I meticulously prepared the materials needed, scrubbed the site for needle insertion and tore tape strips to securely anchor the needles in place.  The student was all eyes as I slid the needles in as painlessly as possible and the patient pronounced it a job well done.  I started the treatment so it was a few minutes before we had time for conference.

“Do you have any questions?”  I was prepared to explain precautions and how the needle placement was selected.

“Yes!  How in the world did you learn to tear tape so straight?  If I ever learn to tear tape like that I’ll know I’m a real nurse!”  Her admiration took me down a notch or two.

“It’s no trick.  You can do it right now.”  I pulled out a roll of tape and showed her it was scored for ease in tearing.

“Wow!  Thanks!”

 

The Joy of Nursing

Early in my nursing career, I cared for Betsy Mercer, a young mother of six and seven-year-old boys who had lost her baby when the placenta detached before delivery.  She was catastrophically ill, suffering every complication. I dialyzed her for weeks while she was on the ventilator in ICU as she went from bad to worse to worse.  The only thing in her favor was her previous good health and the fact that she was a mother.  As a mother, I identified with the grief she’d feel at the loss of her little girl when she finally regained consciousness, and regretful that two little boys were likely to lose their loving mother.  I sang to Betsy and talked to her as though we were friends every day.  “Betsy, Your husband brought these pictures of your boys today.  They are so cute.  He said they miss you but Grandma Sweet is getting them to and from school.  Joey made you this bracelet and Kerry drew you a picture of your family.  He drew you the biggest.  He must really love you.”

I put the bracelet in her wrist every day when I was with her and posted the kid’s art where she could see it when she was turned to the left.  Patients who can’t move are repositioned often to keep their skin healthy and to help prevent pneumonia.  Late one Thusday I finished my shift and told Betsy I’d but would see her Tuesday morning after my long weekend, though I had little hope she’d be there.

I went back to the ICU to check on Betsy before my shift Tuesday morning.  My heart fell when I saw someone else in her room.  I felt just awful till I asked her nurse when she’d died.

“Oh, Betsy rallied midday Friday. She didn’t need dialysis and got off the ventilator Saturday night.  By Monday, she was so much better, she moved out to the obstetrical floor.

I was ecstatic at her recovery, and meant to visit her in her room, but didn’t get up there.  About six weeks later, a beautiful young woman stopped off at our unit to visit.  It was Betsy, fully recovered come to pay her caregivers a visit.  I’d never have known her.  It was such a joy to see her returned to health and her family.  It’s days like these that keep nurses coming back.

 

 

Mother?

We never stop wanting our mothers. That is probably our first and last longing. When I cared for patients in times of pain and need, they often called out for their mother’s comfort. We want out mothers when we are giving birth, traumatized by pain or events, and at the moment of death. Many times I have held the hand of elderly patients whose mothers had to have been long dead and had the patient call me “Mother.” I never corrected them. Who am I to say it wasn’t their mother they saw as they moved on.

Lessons From Michael

A few months into my first nursing job, I met Michael, the patient who put me on the road to true nursing. Still limping down the painful road from enjoying success in nursing school to putting it into practice, I drove home most days thinking, “I can’t go back tomorrow. I can’t go back tomorrow.” I lived in terror of getting caught alone with a patient whose survival depended on all that “nursing magic” that had so far eluded me.  Orienting on an acute dialysis unit, my only useful skills were a pretty good nursing vocabulary, understanding of aseptic technique, and the complete understanding that there was no question too stupid for me to ask. I would have never have made it if my supervisor had been one of those who “ate her young.” (terrorized new nurses)

I was assigned to care for Michael. Though I didn’t voice it, I thought Michael’s family ought to think twice before subjecting him to dialysis. He was thirty-six years old with Down’s Syndrome and its many cardiac complications, diabetic, had hepatitis B, and now needed dialysis. I worried about how he would deal with it at his three-year-old functional level.  Selfishly, I dreaded caring for him, thinking he would challenge my meager nursing skills.

I could have saved my worry. Michael stole every heart in the dialysis unit. He was smiling when his mother brought him in, did everything he was asked, dealt with his pain, and was the kindest patient I ever had the privilege of caring for. I loved him dearly, and treasured every moment I got to spend with him over the short three years I had the gift of being his nurse. Thanks to Michael, I learned compassion and humility. Every soul has value and something to share.

My Condolences

imageOne of the hardest parts of  being a nurse is comforting and supporting the bereaved family at the time of death.  Normally, family members are heartbroken, grieving at the death.  On a few occasions, I witnessed something different.  Mr. Jones, an elderly patient owned a successful insurance agency. Every morning, he donned freshly laundered silk pajamas.  When discharged,  He wore a fine finest suit, shirt, shoes, and hat and took great pride in being noticed.  He bragged of buying a new Cadillac every year, dining at the most prestigious restaurants, and enjoying a membership at The Country Club.

His son, Junior Jones was in his late fifties and had always worked for Daddy.  It appeared Mr. Jones was none to generous nor kind to Junior.  Junior dressed in cheap clothes and drove an ancient compact car.  It must have been miserable since he was so tall he had to fold up like a jackknife to fit in it.  When Junior came to the hospital to consult with Daddy about the business, Daddy was condescending, snide, and critical, never showing Junior the least respect.

One the morning Daddy died, we’d called to notify Junior his father’s death appeared imminent.  Junior came streaking into his father’s room just moments before Mr. Jones’ death.  I offered my condolences.  Junior ignored me, opened the drawer of the bedside table, dug out the keys to his father’s Cadillac, his father’s checkbook and left the room without speaking.  A nursing assistant who was a friend of the family walked him out to the parking garage.  He handed her the keys to his small car and drove off in his father’s big, black Cadillac.  That was different!  I guess he’d had enough.

Mrs. Johnson Sets Me Straight

imageThe time I spent getting to know my patients was the best part of nursing.  As a hospital dialysis nurse, during the course of a four-hour treatment, we had a lot of time to talk.  One of my favorite patients was a lively little seventy-year old lady, the mother of twenty-one children.  I never knew what she’d have to say.  When I expressed my amazement at her having so had many, she told me, “It wasn’t so bad. I had a set of twins, so I was only pregnant twenty times.”

“You must be proud of your kids,” I answered.

“Huh,” she snorted.  “Ain’t half of ’em worth the powder it’d take to blow ’em away.  I gotta keep my purse right with me.”

“Oh.”  I had no other response to that.

She was always full of wild tales about getting the best of her “old man” who was twenty years older than she.  I inferred they had a warm relationship, but she straightened me out when  I expressed my condolences at her next treatment after his death.

“Mrs. Johnson, I ‘m sorry to her of your loss.  I know you must miss your husband.”  I dreaded the lonely times ahead for her.

She cackled.  “I’m glad that old devil from hell is gone.  I thought for sure he was gonna outlive me.  My daddy gave me to him when I wad’n but thirteen years old.  He beat me ever’day long as he was able.  I was so proud when he got old and stoved up so I could take a piece of a firewood to him any time I got ready.  I mean to tell you I whooped him many a time.”

She always gave me plenty to think about.

Curtis, the Church Lady, and Pecan Pie

imageWith thirty years in nursing, you can well imagine I have my share of strange stories.  I worked in acute dialysis in the hospital, so knew my patients very well.  We talked about their lives, familis, dogs, whatever was on their minds.  One of my favorite patients was Curtis, a huge man, perfectly delightful, but developmentally challenged.  His thinking was about on the level of a eight-year-old.  Curtis had somehow gotten credit at a furniture store, bought a houseful of furniture, and not made a single payment.  He was being hounded for payment, so decided the best course of action was to go in the hospital, where he wouldn’t be bothered. When he told the nurse at the outpatient dialysis clinic he needed to go to the hospital, she explained he couldn’t be admitted unless sick.  He did some thinking and called her back to his chair telling her he had something for her.  (I can’t imagine how she fell for that.). He dropped an impressive lump of excrement into her outstretched hand and was admitted into the psychiatric unit of the hospital in short order.

He was happily ensconced at the hospital, soon moved to the medical floor.  One day he walked into my unit asking for a large patient gown.  He went on his way.  Curtis was not on my mind when I heard a lady out in the hall exclaim. “Oh my God! Take it!”  It seems she had been bringing a pecan pie to her hospitalized friend from church when she encountered seven-foot-tall Curtis, walking naked down the hall, looking for hospital staff to help him with his gown.  Curtis, hadn’t seen a pecan pie in way too long.  He dropped the gown, grabbed the pie and raised a clumsy fist when the poor woman resisted.  She gave up on the pie and fled shrieking.  Eventually, the whole thing smoothed over.  Curtis had his pie and his gown.  The hospital gave the lady another pecan pie and an apology.  By the time Curtis got home, his furniture had been repossessed, so he wasn’t harassed any more.  They all lived happily ever after, except of course for the nurse who got a handful of doo-doo.

Knot on Head

imageI used to moonlight at an urgent care clinic.  Mother called me at my regular RN job one day to complain of an earache.  Like I always do when people ask advice, I recommended she see a doctor. She decided to go to the urgent care clinic where I sometimes worked.  I called to speak to my friend, Judy, who was working that day.  I asked her to surprise Mother by telling her she had to have a full internal pelvic exam.  She knew Mother, and was delighted to pull a little trick on her.  Sure enough, she showed Mother to the OB/GYN exam room, telling her to prepare Continue reading →