Sometimes nursing sucks

I walked towards my med cart and there was one of my patients sitting there in his wheelchair, looking like he was ready to spit fire at me.
“It’s 8:20” He said. “I have been waiting for you to bring me my pills so I could eat my breakfast. There is simply no excuse for this.”
“I’m so sorry, I’m getting them right now.” I assured him hastily.
It had been a fairly busy morning, and I was still well within the ordered time for his drugs- not that they were anything critical, anyway, like pain medications, or something that had to be given on the minute.
“I can’t believe this.” He said, and wheeled away from me.
I popped his pills out of their blister packs and checked them against his chart and hurried after him.
“Here you are, sir.” I gave them to him with a glass of juice.
“I don’t want that juice!” He barked at me. “I want my pills on time!”
“You’ll have to excuse me this once.” I apologized graciously. “I’ll make sure they’re on time next time.”
He was still glaring at me and I asked helpfully, “What can I do for you?”
“You can disappear!” He shouted.
That is exactly what I would like to do, I thought. I went back to my med cart and continued preparing for other patients.
By the time I was finished with the morning meds I had mounds of paperwork piling up and one of my patients was pushing his call bell incessantly. I went down the hall to assess one of the patients, an old Scottish man. As I usually do, I knocked on the door as I entered and called out “Hello, Mr. Jones!” in a cheery voice.
“Get the f*** out of my f****** room !” He shouted at me from his bed.
“Uh oh!” I said laughingly, putting on my best Scottish accent, “I was just coming to see how you were”.
“How the f*** do you think I am? I’m stuck in this place, for crying out loud!”
“Well, I guess I didn’t need to ask that.” I returned good-humoredly, approaching the bed warily. I have expected him to throw something at me.
He squinted at me.
“Well, you’re beautiful, you are!” He said in his thick accent. “What do you want from me?”
“I came to ask if you’re having any pain, and if you need any medication for it.”
“You’re medication for my eyes, sweetheart! You ARE a fine looking thing.”
“Thanks.” I laughed, moving some things on his tray.
“You know, if you put on five pounds, you’d be beautiful!” He continued, looking at me critically. “More beautiful, I mean.”
“Well, I’m glad you added that ‘more’” I joked, turning to go in a hurry.
“Now I’d definitely be feeling better if I was married to a young girl like you.” He said. “You just ask Scotty here, and I’ll give you what you want, for whatever you like.”
(And a few more inappropriate comments that I won’t repeat here.)
He pulled a wad of bills from his pocket and thrust them towards me.
“$80.00 is what I go for, that’s not too expensive.”
“Uh….” I took a step back.
“I’d really like it if you’d do a black lace show.” He suggested.
“I don’t think so.” I said good-naturedly, and headed out of his room.
“I’ll see you later!” He called after me.
No, you won’t, I thought as I went out, cause I’m sending the male nurse in to help you get dressed.
On my way back to the nursing station I was stopped by another patient.
“Hello, there! You know, you look exactly like my daughter!”
I smiled. “Well, I’ll take that as a compliment!”
“Oh, it is! She’s beautiful! Absolutely beautiful! And you are the exact spitting image of her. Why, your eyes, your hair, your nose, everything about you! Exactly like her!”
But I certainly hope he didn’t look at his daughter the way he was looking at me.
As I walked past him later in the day he whistled and called out, “Hello, beautiful girl! I can’t get over how much you look like my daughter!”
There were other lines today, too.
Me: “Are you having any pain?”…..Mr. R: “Yes, my eyes hurt every time I look at you, you’re so beautiful.”
Mr. G: “I just woke up from a terrible nightmare!”…..Me: “Oh dear, that’s too bad. Are you feeling any better now?”…. Mr. G: “Well, as soon as I saw you, it ended!”
Mr. B: “Can’t you @#$%#$% nurses leave me alone?”
During my break I locked myself in the bathroom and stood in the front of the mirror, feeling discouraged. Shapeless nursing uniform. Tired eyes. Perhaps they were all blind and crazy. Perhaps I needed to let everything everyone said just roll off my back.
Some days having someone, even a crazy patient, tell you that you are beautiful, is flattering. But then there are other days, like today, when it really does make me want to disappear.

Real life

Sometimes I don't know what I'm thinking. I was at my Spanish class tonight, and we were in Starbucks, and we had finished the class and I was just sitting and chatting with the teacher for a few minutes. We had just started into this deep conversation about life plans when suddenly the door burst open and a man ran in and started shouting and ran behind the counter and was knocking things over.
He was shouting that he'd been shot, and the girl behind the counter was trying to stop him from coming in and he ran towards the back of the store and was leaping around agitatedly. I jumped up (as did one or two other people) and my teacher grabbed his cellphone and dialed 911 and the man was shouting that someone was coming after him. The door burst open again and another guy started to come in but then seeing all the people he just swore at the first guy and threw something down on the floor and dashed out.
I was on my feet heading towards the first guy, my purse poised like a weapon. (I don't know what I was going to do, hit him with it? Use it as a shield?) He didn't have any weapons that I could see and he wasn't visibly hurt or bleeding, which was a relief because there's nothing worse than contemplating first aid on a crazy person that's twice your size.
The girl working there was telling him to leave and he was saying that he was being chased, and then he turned to me and asked, didn't you see that other guy?
Yes, I said. But he's gone now. I looked out the window to see if the other guys were waiting outside. Take a seat, she told him, we'll call the police.
No, don't call the police!
He weaved between the chairs, knocking them over.
To make a long story short, he eventually went out and the police arrived and things settled down, and I ended up sitting and chatting with my teacher and another man who heard us speaking Spanish and came over and wanted to talk to us. I understood about 50% because his accent was so strong, but I nodded along anyway.
I thought about the unfortunate incident as I watched the reflection of circling blue and red lights in the window. Life is not all safe and controlled, is it? When I'm in the hospital there is always a certain risk involved, but there are security guards, and I have tranquilizers to give if I have to, and I am prepared for people to flip out. I'm not prepared for a gun-wielding crazy man while I'm having a quiet coffee in Starbucks. It is a little unsettling.
But that's what life is like- only 100 times worse- for so many of the world, even many in our city. What if I had to fight for survival everyday? Sitting at home studying I feel so disconnected from reality. Real life is not neatly packaged like my textbook. Real life is not quiet and controlled and manageable. Real life requires much more courage and resilience and creativity. Real life is not safe, even if we think it is. But it is an adventure!

Tidings of great comfort and joy

Why haven't I written on my blog for so long? The first reason, I guess, is that nothing much interesting is happening right now. Contrary to popular belief, I don't always have an exciting adventurous life. For example, the last few weeks have been variations on a theme of work with crazy patients, study by myself and feel like I'm a crazy patient, hang out with my family and realize they're crazy to be patient with me. Actually they're wonderful the way they're patient with me.... I am going a little psychotic these days.
Which is the other reason I have been avoiding blogging is that I don't want Happy Heather's Hullaballoo to be an emotional whinefest, because the purpose of my writing is to encourage all my readers, and honestly, what is so encouraging about reading how I'm falling apart? But the truth is, I sort of am.
This morning I sat in bed and was reading in the bible- The apostle Paul tells the church in Corinth that he has been having a tough time in Asia- actually, “(We) were under great pressure, far beyond our ability to endure, so that we despaired even of life.”
Wow, that doesn't sound like Happy Heather's Hullaballoo at all. But it's true, isn't it? And I know deep inside that I'm not the only one feeling that way. I don't think the normal experience of life is always to be slogging through a never-ending pit of hardship- but certainly there are mountains and valleys in life and everyone has to go through some valleys. My struggles as a medical student are real and grueling, but so are the struggles of other people I know who are going through equally difficult things. Plummeting economy and the prospect of losing your job. The day to day pressure of looking after a disabled kid. Getting your heart broken just one more time. Stuck in a difficult marriage. Everyone has struggles, right?
The first chapter of 2 Corinthians strikes a chord deep inside. (Especially cause Paul repeats the same word a million times. See if you can pick up on it.)
“Praise be to the God and Father of our Lord Jesus Christ, the Father of all compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God. For just as the sufferings of Christ flow over into our lives, so also through Christ our comfort overflows. If we are distressed, it is for your comfort and salvation; if we are comforted, it is for your comfort, which produces in you patient endurance of the same sufferings we suffer. And our hope for you is firm, because we know that just as you share in our sufferings, so also you share in our comfort.”
Did you see the word comfort again and again? Does it remind you of a soft feather quilt wrapped around you and a cup of tea and your mom patting your hair as you drift off to sleep? What does all this comfort have to do with suffering?
We're sharing our sufferings. Not one of us is alone in them. If you think you're alone, I challenge you to phone up a friend, any friend, and ask if they've gone through any hard things that week. (Hint: try calling my sister-in-law Yvonne...she had a baby yesterday)
Are we also sharing in our comfort? What is that comfort? Read 2 Corinthians 1... here are a couple that stood out to me.
“Jesus Christ... was not 'yes' and 'no', but in him it has always been 'YES'. For no matter how many promises God has made, they are 'YES' in Christ.”
“Now it is God who makes both us and you stand firm in Christ.”
Can you understand that? God's promises WILL come true. It is him who is responsible for keeping us together. I don't have to worry that I'm going crazy and that I won't make it and that someone is going to have to scrape me off the sidewalk and check me into a mental hospital. Although for the record, if I do end up there, please send me a good looking doctor.

91 and kicking

You know what I want to be like when I am 91 years old? Just like the patient I had last night.
I came into his room to bring him some pills and he grinned from ear to hear.
“Come right on in, don't be shy!”
I looked at the pictures of his family he had and talked to him for a minute about the weather outside.
“Do you know how old I am?” He asked me with a twinkle in his little blue eyes.
I decided to guess on the low side.
“80?”
“Higher.” He said.
“85?”
“Higher”
“89?”
“Almost! I'll be 91 in January!”
“Well, you sure look good,” I told him. “And best of all”, I pointed to his forehead, “You still have all your faculties.”
“Oh yes, I do!” He crowed. “How many 91-year-olds do you know that can say the ABC's backwards?”
And then without a pause he began to rattle off the ABC's in reverse.
“And how many 91-year-olds do you know that can say this sentence fast, three times?” He asked, and then proceeded with something like “I slept on three slit sheets that sure slipped sleet like shirt sheets”... or something like that.
He rattled it off three times in a row and that beamed at me. “See if you can say that one.”
Growing up with brothers has made me wise to that type of trick. I shook my head and laughed.
“I don't think so.”
I finished giving him his medications and he offered me some grape-flavored candies as I walked out of the room I could hear “slit sheets slipped sheepishly...”
Ah, the joie de vivre! On days when I feel discouraged I will think of him: bed-ridden, in pain, alone; but full of zest and still trying to trick some gullible nurse into saying something rude.

All in the head

Sometimes work just makes me stop and laugh. I have the craziest patients ever. I often thought that if I worked in a field of nursing with young, vibrant patients who were relatively normal, I would’ve stuck with it and not gone on to medicine. But actually I think the crazier patients really reassure me. They make me feel normal and like I’m not actually psychotic, it’s just in my head.
Yesterday, for example. I approached one patient and as I came up, he said in a very loud voice so everyone in the vicinity could hear,
“Now THAT is one GOOD-LOOKING girl!”
I was sort of embarrassed as I handed him his medication and he leaned over and squinted, trying to read my nametag.
“Heather, LPN. What does LPN stand for?”
The guy next to him groaned.
“Come on, Ray, give her a break.”
“hmmm…. Liquid…. Propane….”
I interrupted him. “It stands for little pretty nurse,” I said.
“Haha!” He rocked back on his chair. “That’s a good one! Little pretty nurse! Well, I’m not asking your age, that wouldn’t be polite, but I don’t know if I should call you a lady or a girl, you look much too young to be a nurse!”
“I’m 24.” I told him, “Which is much too young for you, by the way, so don’t get any ideas.”
“Are you kidding? 24? Why, I thought you were about 16!”
He started laughing and elbowed the guy next to him.
“I know! Sweet 16 and never been kissed!”
I had finished with his medication so I just gave him a withering look and walked away.
Later on I had to come back and see him again and I swear, it was like he saw me for the first time.
“Well, hello! I’ve never seen YOU here before! Where did you fall from? Are you an angel fallen from heaven?”
He looked down at my nametag…. “Heather, LPN. Hello, Heather! Well, what a nice-looking girl you are!”
A bit later in the day one of the other nurses came rushing towards me.
“Heather, can you go to the front door? Mr. Roland is out of control and I’m trying to get the doctor but Mrs. Taylor isn’t breathing…”
“Sure, no problem.”
I rushed to the front door and Mr. Roland, sitting in his wheelchair with a couple of nurses fluttering around him, was like a seething giant about to explode.
I put my hand on his knee and crouched down to meet his eye.
“What’s the problem, sweetheart?” (I couldn’t remember his first name.)
“Get the hell out of here!” He shouted and lifted his leg to kick me.
I leapt out of the way just in time. Well, maybe that approach wouldn’t work. He had a gash on his head that someone had put steri-strips over, and there was a massive purple bruise under his eye. He was talking nonsense, saying he wanted to get out, but he was so unsteady on his feet that he couldn’t stand up. I came up behind him and put my hand on his forehead to feel the temperature, then leapt out of the way of his flailing arms. No, he wasn’t hot, or sweating. I tried to think of the things that make people suddenly aggressive and psychotic. An infection could do it, but he didn’t have a fever. The fall on his head? A stroke, acute pain, drug interactions, alcohol, dementia, there are several possibilities. But with him in this state we couldn’t even examine him. There were already people staring. Another nurse came down the hall.
“The doctor finally gave me an order for an IM tranquilizer.” She said, pulling me aside. “See if you can get him out of the lobby and towards the nursing station.” (IM means intramuscular)
To make a long story short, it took a lot of negotiation, including bribes (“Coffee? We’ve got your son on the phone to speak with you…”) to get him out of the lobby.
At the nursing station there were people everywhere and he stood up shakily and held the receiver to his ear to talk to his son, shouting and flailing around. Suzanne, one of the other nurses, had drawn up the medication in a syringe and was standing off to the side.
“I don’t know if we can do this.” She said. “He’s wearing about 3 layers. We’ll have to get all those sleeves off so I can get it in his arm.”
“No way.” I said, pointing at his butt. “Go ventro-gluteal. We’ll hold him down and just get his pants down a bit and stick it in.”
Mr. Roland was shouting and throwing punches. One of the other nurses had nail marks on her arms and decided it was time to back off permanently. We waved over a couple of male nurses and Suzanne and I came in and I grabbed his arms and hung on for dear life and Suzanne got that needle in and he roared like a cornered bear and threw us off, but it was in. I felt like a superhero. We all retreated a few feet back and watched as it slowly began to take effect. One of the guys came up behind with his wheelchair and I approached cautiously.
“Here, Mr. Roland, have a seat.”
He slowly slumped down, mumbling, “Get the hell away from me. I don’t want anyone to touch me. What are you doing to me?”
And that was that. An hour later the doctor had seen him and he was sitting calmly, eating fruit salad.
And I was down the hall with my patient Phil who between gasps told me he couldn’t breathe and he was sick of suffering and wanted to die right now. I turned his oxygen on and went to get a bronchodilator and by the time I got back he was breathing normally and when the other nurse asked how his breathing was, he said it was no problem. But we checked his O2 sats (a measurement of the amount of oxygen in the blood) and they were at 86% (normal is 98%) and suddenly his chest was heaving again with the effort.
Crazy guy. I think if I couldn’t breathe I’d let everyone know.
So anyway. This week is week of the heart for me, and I’m wondering what’s going to go wrong. Week of the stomach I was nauseous and throwing up, week of the lungs I had bronchitis and was coughing away…. Hmmm….. maybe it is all in my head after all.