Don't cluck at me

Last night I had a patient of whom I can honestly say I didn't care for. Despite the humor related to my patients, I generally do like nearly every single one of those bowel-fixated gems. But once in a while, I get a patient who rubs me the wrong way. And makes me wish it was legal and ethical to smother them. (Remember, this is a humorous blog, not at all intended to be serious...or murderous...) At any rate, this one patient is a younger female, on a vent, who has become quite the manipulator. This description is her family's assessment and I completely concur. This gal, bless her heart, has limited muscular ability. She wiggles her eyes or eyebrows to indicate yes or no and I am pretty adept at asking the right questions to discern her needs. Well, maybe sometimes it takes more than twenty questions, but I never said I was a mindreader. This manipulator has a habit of clucking her tongue which sounds like a loud squirrel during mealtime. At first, I didn't mind. But after twelve hours of her clucking furiously for one thing after another, having me figure out a new request before I was finished with the last task left me wanting to run over every middle-of-the-road squirrel on the way home. And aim for a few on the sidewalks. I used to like the cute sounds of squirrels. Now I want to bring out my BB gun and silence them all. Do nurses experience post-traumatic-stress? You bet.

Yet another pee pee story

Recently, I had a patient of whom rang all.night.long. to use the bedside commode. In the morning, I had already given report and was headed out the door intent on enjoying a sunshine snooze. The patient in 13 had other ideas. As I collected my things I heard the insistence of the call bell ring-ting-tinging away. Despite my internal warning bell hammering at me to let the tech get it, I set everything down and wearily entered the House of Urine.

I assisted 13 to the bedside commode and waited as she took her bladder for a walk and left a few kids off at the pool. Then I got her snuggled back into bed. Not one to leave a mess for others, I figured I would quickly empty the bucket and then scoot out the door. Ah, but no. Some joyful wingnut left some kind of plastic inner liner in the bucket which caused the Niagara of Bowels to rush out, skid along the rim of the toilet and land squarely on my sneakers. Sneakers which are generously vented on the top to reduce sweating.

I scooped up the poop and sopped up what little my socks and shoes did not suck in like a roll of the Quicker Picker Upper towels. No one had to ask when I walked by what had happened. The telltale squeaking of my smelly UTI shoes was all the information the laughing crowd at the nurse's station needed. Ah....I love my job.

I decided to answer Friday's Five with a nursing theme:

1. If you had a jar of peanut butter, what would you do with it:
I would put it on the roof of 317-2's mouth so that it gave him something to do rather than yell, "What's that? What are you doing?" every time I go in to see his roommate.

2. If you were to be creamated, where would you want your ashes to be and why?
Scattered over the college in which I am trying to get my next degree so that my spirit would somehow feel as if I were still attending classes.

3. If you could invent a flavor of jelly beans, what would it be?
"Be Nice To Your Nurse" so that it would remind patients that I am kind and helpful to them so they should return the sentiment. :)

4. If you could fly, where would you go?
Hawaii where I would learn to surf.

Lately, it seems, my patients have been wonderful, except, of course, a few who smudge the happy feelings like a water drop on a sheet of loose leaf paper. I had one patient the other night who is mentally challenged. He was so delightful, smiling and thanking me for each cup of juice. I was so taken with his utter glee that I sneaked him a piece of cake that one of the girls had brought in. It was okay with his diet but it is not generally acceptable to ply patients with nurses' food.

Then there was the guy who had an injury to his buttocks. He was well over 90 but was so modest that when I came in to assess him, he would not let me enter his room until he hurridly yanked the gown over his genitals. It was cute. At first. Until he insisted that I not be in the room while he stood to use the urinal. He was a fall risk. He had had a bad spill at home already. He was unsteady on his feet. Wobbly. Slipping. Sliding. No gripped socks were going to keep him upright without a helping hand. Yet he insisted that I not help him. Time and time again the alarm signaled me to his leaping out of the bed to try to pee before I came in. After six or seven times, it was not quite as funny as it was the first time. I tried compromise, asked others for ideas. We tried other ideas. Nope. The only one he opted for was me out of the room while he stood bedside inside the room. It was a long 12 hours. I nearly ran out without clocking out.

Many days, this job is rewarding. Some days it's a little tougher to enjoy nursing. But overall, it's a great career and serving others in their time of need can never be beaten...everything else would just be a job.

The Pee Pee Story

Ever have someone tell you something about themselves that is so ridiculous that you are sure it's not true until you witness it yourself?

That was the case last night when one of my 20-year old post op patients told me that he hadn't voided in hours. A key event to watch for post op is the return of the innards working, mainly the pee pee and poo poo sections. The day shift nurse warned me that she had to straight cath him, meaning stick a rubber straw into his penis to drain the urine from his bladder. She told me he was a little shy. We both chalked it up to his young age, and older nurse, and the anesthesia. We were wrong.

Hours later, "Joe" complained of bladder fullness. I lead him to the bathroom so he could relieve himself. He told me he was sure he wouldn't be able to pee as he was shy. I shut the bathroom door and told him to give it a few minutes while his body regained control from the twilight drugs.

His mother met me out in the hallway and reiterated that he was shy about going to the bathroom in public. I looked at her and reminded her that his bathroom door was closed. She then told me, "No, Joe doesn't pee in public. He's been this way since he was a child."

Perplexed, I asked her exactly what she meant. Are you kidding me, lady? He's a guy for heaven's sake. They'll pee anywhere, I thought.

"Really. He will hold it all day so he can pee at home." What? This is crazy. What if he has to take the kids to the pool? He squeezes his cheeks together all day?

"Joe is shy. He's not going to be able to go. You'll have to cath him." Wait a minute. One of the girls who graduated with him told me he was voted best couple with his girlfriend. Captain of the football team. And he can't do his business unless he's on his own throne? Gosh, these people are weird. I always get the weird ones.

So I assured the mother and the patient who was unsuccessful at this attempt that he would pee by morning. I was wrong. Twice. Twice he asked me...ASKED me to catherize him. Now I know I'm not a guy but if I was a good-looking 20 year old football star I would not, under any circumstances, ask a stranger to shove a hard straw up my wiener.

He asked me, "If you cath me, would it embarrass you? I mean, would it freak you out or anything?" No, I told him, I could cath a watermelon and it wouldn't freak me out. I came close to telling him about the 400+ lb woman of whom my entire arm disappeared when I cathed her but I thought the mental picture might shrivel up his weiner so I was playing catch the turtle so I could cath.

As I had the death grip on his squirmy wee wee, he asked me if cathing him would permanently injure his manhood. This was the second time I cathed him in 12 hours. It was a little late to be worrying about his hot date next week.

Some of us joke that we rarely see any truly decent-looking male patients. I finally got one and he turned out to have penis psyche issues.

Manly, the 90 year old flirt

Manly is a 90 year old fella who is what we call a "frequent flyer". He's admitted about once every other month. He's a taller, thinner version of Spencer Tracy with a white shock of hair and a grin which makes all the girls fuss over him. Too bad he's a victim of Alzheimer's, my most hated medical enemy. Unlike many who suffer from this disease, he's quiet, non-threatening, and tries to be compliant. Well, at least for about twenty minutes at a time. Then the bed alarm warns us that Manly is climbing out, most certain to fall. He's had many falls and is quick as any five year old. But he never gets angry when we redirect him to bed.

"Manly, it's two a.m. It's time for bed, " we'll say.

"Oh, it is?"

Then he lets us tuck him back in...until he forgets and we repeat the process all over again. About twenty times a night. Every night until he goes back to live with his wonderful, caring son.

So one night cute-as-a-button Manly was up to his usual rail-climbing, paying no heed to the wailing bed alarm alerting us to his intent to wander.

I went in and resettled Manly and tucked him back under the covers. Manly beckoned me closer with a wave of his hand.

"What's up, Manly?" I said.

With a glint in his eye, he murmured, "So, are you in the mood?"

Stunned, I blurted out the first thing that came to mind, "No, Manly. Not tonight. I've got a headache."

I could hear the girls in the hallway trying to stifle their laughter.

"You do?" Manly asked, as disappointed as a guy on prom night whose date told him she was on her monthly.

"Yes, Manly. I do."

Manly thought a moment and said, "Are you sure?"

"Yes, Manly. Not tonight."

In a clear attempt to change my mind, Manly called me closer still and said, "I'm hung."

I bet that's what he said to all the girls....

I am not a psyche nurse

What to do when you want to smother them with a pillow? Take a walk to the other side of the unit; there's bound to be a nurse with a worse group than yours. The other night I had five patients. Five instead of the usual six. I thought for sure it would be a cake walk. However, sadly, I was wrong. Two had urine which tested positive for benzos, opiods, marijuana, and alcohol. They were PISSED that they could not get pain meds around the clock. A third patient was schizophrenic. She talked to herself. Kept saying, "There she is. Get her. Get rid of her" every time I entered the room. This made me repeatedly wonder if she harbored a weapon under her sheets. The fourth was a dementia patient who ignored the siren of a bed alarm and leapt out of bed to the bedside commode Q20 minutes. All. Night. Long. And she was darned feisty about it! The fifth, God bless her, was a lovely elderly woman who was so pleasant despite the gaping diabetic wound that she called her right foot.

That night I hung more antibiotics that I had in the three weeks previous. And I said, "No, you cannot have any narcotics" more times than in the previous year.

However, despite the long twelve hours, at least I didn't have the patient in 335 who screamed over and over and over "Help me!"

The Passing of Travis Alexander

I never met Travis Alexander of Mesa, Arizona. In fact, until last night, I never even heard of him. Turns out he was a successful motivational speaker, entrepreneur, and a dear brother, nephew, and friend of many. I guess they were lucky people from what I hear. But he's gone now, the victim of a terrible murder. There's someone who has been arrested and will go to trial. Although, initially after watching the "48 Hours" episode last night, I had an opinion as to whether or not the accused was or was not guilty, I think now I would rather leave that up to the court and instead focus on the message of Travis Alexander.

As a nurse, it's my job to try to save people, to reach them and somehow make a connection to in some way touch their lives in a positive manner. I am a nurse so I care. But this Travis Alexander, at the age of 30, well, he wasn't a nurse yet he chose to care enough about others to post up an insightful web site and a blog in which to reach out to others. In writing, he was able to learn more about himself and who he wanted to be and chose to share it with others. He chose to share his thoughts and his faith with others. I'm not a Mormon like Travis Alexander was, but I have to admit his statements did make me wonder a bit about a religion I've heard about but not enough with which to fill a thimble. And I think maybe that was part of his message. To share, garner curiosity, and cause action in others' lives.

I know as for me, writing my blog is to enlighten other new nurses and nursing students what it's really like to be a nurse. Cathartic for me, too. I wonder if it was for him. I spent time I should have been reading the text for my BSN class instead reading about Travis Alexander, his friends' thoughts, and the small bits he himself posted. It is sad that he has passed. Not a surprise to God but it makes me wonder why so soon before Travis Alexander was able to reach more people. But maybe he reached enough. Sparked some of us to enjoy each day more than we tell ourselves to now. I am sure when I get to heaven I'll hear about this guy whose goal it is to praise God full tilt no holds barred. It'll be him, I am sure.

Travis Alexander did touch lives. Some before he passed. Some after. But he did complete his mission to share the joy of life with others. For me, my early life was difficult, filled with poverty, moving, and uncertainty. But I wouldn't change it because it made me who I am. It drove me to complete a nursing program despite long, long odds. It gave me a closeness with my brothers and sister that I cherish. It made me strong enough to keep ticking off the "Life's To Do List" that I wrote in high school and still carry with me today. Be a hard charger. Tackle challenges like you know you will win. Be your own hero. And remember Travis Alexander. He sounds like he was a good friend but a better admirer of the fullness of life's journey.

I use his name in full, Travis Alexander, because he deserves to be remembered. As we all do.