Friday, February 13, 2009

Pledge

It's amazing what one will do for ice cream. The administrators at my hospital came around the floors Tuesday night offering ice cream & chocolate in exchange for us signing some type of pledge. They didn't let us read it....just said "It basically means you're going to be nice to the patients." Do we really need to have that in writing? Isn't it a given? Speaking of administrators....I only recognized one of them because the rest are all new. And by new, I mean they are coming in & changing everything....life as we know it. I've been at the hospital 5 years now...I've seen plenty come & go. I'm sure it will be no different with this group. They step in, change everything, then decide it's too stressful & leave. I'm sure it's that way everywhere.

Work wasn't bad this week. I was busy, the hospital is super busy....but nothing too bad as far as my patients go. I did have one....a 93 yr old woman who had a stroke a few months ago. She can't speak or move the left side of her body. She does make garbled noises - it felt like I was taking care of a baby. It's weird how life can take you back to that age - does that make sense? In days prior, she kept pulling out her NG tube...it's what we were using to feed her with since she was unable to swallow food properly. Personally, I saw it as her saying "That's it, I don't want this, let me go peacefully, it's my time." The family however saw it as "It's time to have a feeding tube inserted into her stomach." As a result, we had to restrain her right hand, so she wouldn't pull anything out....like she wanted to do.

The first night I had her, the daughter called me into the room & said "She's complaining of pain." I wasn't sure about that as I was told this patient doesn't speak. So I asked "How do you know she's in pain? Did she tell you that?" The reply..."No, she's pointing at her knee." Huh??? Has that become the universal sign for "I am in pain" & no one told me? I ended up repositioning her so the family would be happy. I think they just wanted her medicated so she'd sleep - but that's not how I do things. In the back of my mind I was thinking though that this should have been a hospice situation or at least a consult.

The next night the family calls me in there again & says "She's complaining of pain." I ask "Is she speaking today?" The reply "No, she's moving her right hand." Huh??? Are you serious? That makes you think she's in pain? I told them "She doesn't like being restrained, that's why she is moving her right hand - she is telling you the best way she can, she doesn't like this." All they said was "Oh." I don't get it.

I really try to picture it being a relative of mine & if they were 93 yrs old & just laid in bed all day moaning...I would like to think I'd try to do something to help even if it's the undesirable choice. I've already had this discussion with my parents & what they would want me to do if it came down to a feeding tube & not much quality life left. We all have the paperwork filled out. I wish more families would have these discussions so the right thing can be done. When it comes to death & dying, our pets get better treatment than we do - because no one wants to see a pet suffer. Somehow though, families overlook this with their loved ones. I guess there is hope that they will get better & be who they used to be. I don't know.

I did have a 91 yr old lady that came in with chest pain. She was the cutest thing ever. She complained of chest pain right before 9 pm. Then she says "I took my medicine, the pain went away." And she went to sleep for the night, woke up at 6 am, MADE HER BED (didn't I tell you she was adorable?) & sat in her chair talking about how she cleans her house. Way too cute - I wish they could all be like her. It's the first time I've ever seen a patient make their own bed. Of course her roommate couldn't take the competition....she was a 75 yr old that also got up at 6 & made her bed. I could really get used to having patients like those.

I had thought about going back to work last night for an extra shift, but the full moon was definitely out & half of the patients were confused & screaming & doing weird things. One was screaming as though she was being murdered & she woke everyone else up Thurs morning. There were just way too many signs I was seeing to stay home.

I'm picking up the niece & nephew & going to my parents house tonight. Time to catch up with family before returning to work Sunday night for another 3 in a row.

Have a good weekend!

p.s. Pamela - can I be invited to read your blog? I tried, but it says it's private.

4 comments:

Julie said...

I can't believe it but your making me miss work! Even the screaming patients. I have told my husband and sons exactly what I don't want when I am in that state. Poor woman.

We have been having lots of changes at the hospital I work at also. Getting ready for socialized medicine and getting rid of social workers, pastoral care, anyone who doesn't do direct patient care. But they are a important part of the team. I think things are going to get worse. I had better get healed up and back to work while I still have a job.

Pamela said...

Families try to do what they can to "save" the patients so that by the time we at Hospice get the referrals, they die very soon. It's annoying. If the referral was made earlier, we could make the pt comfortable at the last part of life. I just had 2 admissions that both died within 2 days!
Families need to get the information sooner. AND they need to understand it. They are all in such strong denial.

Send me your email and I'll add you to my journal and send you a link. ok?
Send it to LAnurseprn@aol.com

dx_acutefelicity said...

there was a picture in the local paper today of nurses being given godiva chocolates by the hospital people for the care they give the patients. it made me think of your post.

thanks for the comment and for adding me to your bloglist! :-)

*meira

mandy said...

I am just amazed by what you do! You face such tough situations and you do a great job.