Oh the things that nursing has taught me!

I think back to what I thought nurses did when I was in middle school. I thought it was getting people on and off bed pans and putting on band aids. When I was in high school, I unfortunately got an inside view of what it was like to have a loved one in the ICU, when my brother was involved in a serious car accident. Fortunately, I have repressed most of the memories of him being in the hospital, though I do remember thinking it would be cool to be one of those nurses. I vaguely remember seeing him on the ventilator and remember him having two chest tubes, as I vividly remember sitting on the chest tubes. Oops! He got really upset about that.

Now, I know that to be a nurse you get A LOT of people on and off bedpans; that is if you are lucky enough that they tell you in time, never put on band aids, and sterile gauze and lots of tape can really cover almost any wound. You must learn to have the patience of Job. You are a part time therapist and full time rule enforcer. "Don't use your arms to pull yourself up, they just cut your chest open. Please keep your arm down, that arm has an IV in it that is monitoring your blood pressure. Nope, sorry you can't sleep on your side like you normally would, because you have too many lines and tubes coming out of you."One must also understand the balance of wetting a patient's mouth enough that they don't feel as though they are in the Sahara Desert but not so much that you exceed your fluid restriction goal for the day in 12 hours. The fluid restriction goal if just post-op because cardiac patient's get a lot of fluid in the OR. It is not uncommon for them to come out of surgery 10-15 pounds heavier than they went into surgery. We remove most or all of that weight post-op with diuretics. You must also be persistent enough that when your patient says to leave them alone, you will return the next hour smiling and pretending that the prior rudeness never occurred.

I started thinking of all of this because the other night I took care of a gentleman that reminded me of an angry George Jefferson. I am not kidding this man looked just like him. I was walking around like George did and yelling "Weezy!' as this is what he called his wife Louise. Then my bubble was very quickly popped when a young lady said, "Who is George Jefferson?" My heart sank, as I can remember being her age and asking someone of my grand ole age a similar question. "Oh no! I am old to these 20 somethings." Where has the time gone? I am going to pick myself up now and continue on here.

Let me preface this conversation with, I believe this gentleman had some underlying dementia that the family has refused to admit for sometime. Then you put him in an ICU where the lights are always on, there is constantly someone in his room, strip him of all modesty that he ever thought he had, and give him a lot of different medications that are not usually in his medicinal regimen. This my friends is the perfect storm.

I walked into this gentleman's room smiled and introduced myself as I always do and then asked him if it would be okay if I listened to his chest and belly. His words "Nope, not today lady! Move on. I am very sick and tomorrow I am hoping to be better." This was a gentleman that had open heart surgery two days prior and was still in the ICU because he was on an IV medication to keep his blood pressure down. I explained to him that he was in the hospital because he had open heart surgery and that it was my job to take care of him for the night because he was still very sick. His words "Woman, I know I am sick. I am the one that told you! Now do me a favor and leave me alone!" Some people are a bit confused but you can act like you are doing one thing and actually perform most of your assessment. I pretended to be fixing an IV on his arm and tried to slip a thermometer under his arm. That went over like a lead balloon! Here came the fist flying at my head. Luckily, I spent a lot of years reenacting the karate kid wax on and wax off and I was able to deflect the left hook. I am persistent but not stupid. So I updated the charge nurse and provider for the evening and they said to just leave him alone as more stimulation would make him worse. Later he started pulling on his IV's and Foley catheter, so he bought himself some mittens. These are not restraints but look like Mickey Mouse gloves and just prevent him from pulling anything out. Those mittens took 3/4 of his fight out of him. He looked similar to a dog that has to wear "the cone" after surgery to keep them from licking
 their incisions. It made my night go so much smoother. The second night, while he was more agreeable to what I needed to do, he was still quite grumpy. I ended my two nights with him with him yelling "Woman! Just leave me alone!" I told him the pleasure was mine. :-)

But it got me thinking of the time a patient fired me as his nurse. The time I was kicked. I have been spit on. That ended quickly as I just put a mask on him. That really made him mad. He was restrained so he couldn't get the mask off. Don't get me wrong the good patients far outnumber the bad. Patients like this gentleman really makes me appreciate the good ones.

Nursing has only honed the skills that I have mentioned above. I still love my job and am loving traveling. Patients like this gentleman just make for good conversation. It would just be boring to talk about the normal and nice people that I have met. I have a select number of patient's that I still keep in touch with and I really enjoy that they choose to keep me in their lives.