This has been a busy week. I started Sunday night & by Thursday morning - my feet were aching. We have had something like 3 or 4 Baker Acts = no patient care techs to assist the nurses. That is my pet peeve with this hospital. They don't seem to care that we are short-staffed or overburdened. I don't think they realize how much difference a good patient care tech can have on a unit.
Sunday & Monday were busy, busy nights for all the nurses. We were all exhausted by 7 a.m. How I managed to work 4 nights in a row with that patient load - I don't know.
Two patients stood out for me this week. One was a woman in her 90's that came in with chest pain. Normally I love chest pain patients because they are the easiest to diagnose/treat. However, when they are elderly - the chances are high that they also have some degree of dementia. Mine had that along with paranoia. The thing is though...she was telling us stories that seemed so believable...at first. It is strange how the mind works though - I mean she couldn't remember where she was or why she was there, but she knew her friend was stealing stuff from her house & dropped her off at the hospital, but told her it was a hotel. The more she expanded on her thoughts, the easier it was to see how delusional she was. Monday night when I came in - she was refusing to wear her heart monitor. I would go in the room, put it back on her & explain the importance of it - only to see within 30 min, it was off again. She would also get out of bed & stagger all over the place. She was a fall waiting to happen. So I tried to put a Posey vest on her - just to keep her in bed. That didn't work as she fought me when I tried to put it on her & she started yelling & screaming. This is really nice when it happens with another patient & their family in the room.
My clinical leader came in & tried to calm the woman down. She then turned to me & said "Get the wrist restraints." So we put her back in bed & applied the restraints - which only made her worse. She wouldn't stop yelling & screaming. Again, this is always so pleasant when there are other people in the room. @@
I ended up calling the doctor & getting an order for Haldol. She slept pretty much the rest of the night. I did end up moving the other patient into a nice, quiet room. When I came in the next evening, she had been discharged....yay!!!
My other patient was one that had a stroke. The left side of her body was affected - she could barely move her arm & leg on the left side. Her attitude started out very sweet the first night. By the second night - she was in denial. The doctors were telling her & her son that she would have to go to a rehab/nursing home in order to regain any use of her left side - they couldn't send her home like that because she didn't have anyone to take care of her. She was adamant about not going to rehab. She wanted to go home & that was that. I tried to explain to her the reasons a rehab was necessary, but she didn't care. She had also gone from being sweet to being very grumpy & irritable. She even called her son to tell him I was mean! ME?????? Mean??????????? No way!!!!!!!!!
I tried to put myself in her state of mind - the best that I could anyways. I had a lot of patience with her because I realize that this has to be quite stressful & worrisome. Her thought process was still in tact 100% - so she knew exactly what was going on with herself.
The next night when I came in, she was still a little grumpy - but more accepting. She knew there was no other choice than a rehab facility. As the night went on, she was beginning to express herself more & more...not in a good way either. Around 1 am, she called for me & I could tell something was wrong emotionally. She was on the verge of tears so I asked her what was wrong. She opened up about her fears - that she was worried once she went to rehab, she'd never leave - that she'd never make it home - that she'd die there, she was worried about her sons, she was worried because a friend of hers had a stroke & died within a week. She expressed her fear of dying.
It was really touching & it really made me take a step back & try to understand her worries. It also put my life in perspective & gave me the reminder that none of my worries compare to hers right now. Her life is changing & there isn't a thing she can do about it at this point. I do a good job at drawing the line & not getting emotionally involved with a patient or their family. I need to have that line in order to survive in this line of work. I don't want to take patients worries home with me - it will wear me down & burn me out. I have been thinking about her a lot though. How could I not?
I work Sat & Sun nights - have Monday off - then work Tues, Wed & Thurs nights. Busy, busy, busy - but I have to be in order to pay off these dental bills. I had a root canal last week that was like $900 and I see the dentist again this Monday for a couple of fillings that cracked. It seems neverending!
I took Shay to the dog park today for the first time. I took her at noon time & there wasn't a single person there...lol. So we went back around 5 pm & stayed until 7. It was crowded - I was surprised. She was a little on the shy side. She preferred to hide under the picnic table where the big dogs couldn't reach her...then she'd run out to get their attention & run back to her hiding spot. She got braver as time went on. Now she's exhausted & already asleep. She's doing well though. She'll be at doggy daycare this weekend. I hate leaving her there overnight - knowing she's all alone, but it beats coming home to a house full of dog accidents. My parents have been watching her while I work, but I figure they need a break. They treat her like a child - my mom keeps her by her side all day and my dad takes her for rides on his golf cart. She's spoiled...that's for sure!
Have a good weekend everyone!