Friday, January 8, 2010

Not A Hussie

The way our ER is designed, one of the patient treatment rooms, Room 15, sits directly across from a physician work station, a place where we can sit to do our charting, catch up on computer work, use a telephone, and review computerized radiographs.

We have several similar stations throughout the ER, but this one is unique because of the direct view it shares with Room 15. Despite our best efforts to keep the curtain drawn and the sliding glass door closed to this room, there are many moments when a patient and their family can "people-watch" us in the midst of a shift. I actually feel like someone might toss me some peanuts if I clap my hands and dance for them.

It works the other way, too. A screaming dementia patient can ebb away at your last thread of sanity in the middle of a crazy shift. The smell from a patient with a lower GI bleed can give you dry heaves, and the lingering apple-scented spray used to cover the smell only makes things worse. Even the conversations that are overheard, from critiques of the physical characteristics of our nursing and physician staff to the sharing of in-depth personal confessions and secrets, are enough to make one wish for an instant cement-block wall. Graffiti optional.

During one recent shift, because of the noise emanating from Room 15, I was quite happy not to be sitting at this particular station. One of my partners was, however, and I needed to talk to him.

As I walked down the hallway towards the station, the screaming and ruckus only intensified. I found the physician and connecting nursing station bare of any warm bodies and suddenly, I was worried about the happenings in Room 15.

I walked quickly into the room to see if I could be of any help. What I found was one of our recently-hired graduate nurses, Michelle, at the bedside of an elderly woman who obviously suffered from dementia. The patient was aimlessly yelling and aggressively trying to climb out of her bed. Michelle was struggling to get the patient back into her cot and despite her best efforts, this 100 lb. frail little lady was succeeding and now standing at the foot of her bed, all in the blink of an eye.

"Michelle," I asked, walking to the patient's other side as I spoke, "where is everybody? What can I do to help?"

"I think the patient in Room 18 crumped and everybody ran in to help" she answered. "Can you help me get Mrs. K. back into her bed?"

"Of course," I said, thinking this would probably be the easiest thing I would be asked to do during this shift.

Together, we tried to coax Mrs. K. back into her cot. Unsuccessfully. Mrs. K. had other ideas, I suspect, of taking a self-tour of our ER. It seems for every step back we convinced her to take, she took two forward. And she was a strong woman! Why does it seem that the more frail a patient appears, the bigger their can of whoop-ass? She was whooping us, no doubt about it. Heck, I thought, she wasn't even my patient!

Finally, I had had enough. Michelle and I were simply not going to win this battle. I work out often and although this woman's spirit was big, she did just weigh 100 lbs. So with that, I bent over, scooped up Mrs. K. in my arms, and easily placed her back in her bed. Problem solved. In fact, I suspect Mrs. K. enjoyed the ride. As soon as we got her back in bed, fluffed her pillow, and covered her with a warm blanket, she started napping, her outburst a thing of the past.

Guess what, though? After I picked up Mrs. K., I found my right arm, the arm I used to scoop her up, soaking wet.

"Michelle," I asked, "what do you think this is from?"

"Ughh, gross," she said, staring at my drenched arm. "Maybe she had an accident."

Do you think? I looked at my arm and my mind went rampant imagining what the wet was from. The best I could hope for was that it was something yellow. You gotta love Mrs. K. She showed me who was boss after all.

I went to our sink and scrubbed my arms with disinfectant soap. Twice. Three times. When I was done, I smothered myself in antimicrobial gel. That should take care of the juicing I just received.

Wrong. Soon after I returned back to my patients, I discovered a rash starting on my right arm. Only my right. The one that had the wet stuff on it. I looked at it and wondered, as you would, what the hell???

It was definitely a urticaric rash, better known as hives. What could Mrs. K. possibly have given me? Had she been a promiscuous hussie in her youth? Did her urine contain uranium? Was I allergic to recycled apple juice? I was cursing myself for being a good Samaritan. Was getting a rash on my arm worth this?

Of course it was. I would have helped Mrs. K. and Michelle again in an instant.

I went and washed my arms again. Twice. Three times. Then I took 50 mg of Benadryl and changed into a long-sleeved shirt.

I obsessively kept checking my arms. And after about fifteen minutes, I noticed something that made me feel a lot better. Made me smile, actually.

My left arm was getting a rash on it, too.

Why would I possibly be happy to be getting the rash on my left arm, too? Easy. If the rash were only on my right arm, then that unknown wet stuff would have been the source. But...if both of my arms were afflicted with the rash, then it obviously had to be from either the soap or antimicrobial gel I used. My left arm never had anything wet on it.

Washing my arms six times and smothering them with gel twice had gotten to me. Mrs. K., thankfully, had nothing to do with my affliction after all. And sure enough, after about an hour, the rash started going away. On both arms. Shame be gone.

Mrs. K., I owe you an apology. I didn't really think you were a promiscuous hussie in your youth. I promise. In fact, I really enjoyed meeting you as you reminded me of my grandmother. And wherever you are, I hope you are well and still showing the world your indomitable spirit!

Just not in Room 15.

As always, thanks for reading. Next post will be Monday, January 11th. Have a great weekend.


rlbates said...

Wish I had your gift of story telling. Wonderful!

Maha said...

At least Ms. K didn't develop an instant crush on you as soon as you scooped her up! That happened to one of our ER docs. A little old lady with dementia started hooting at him every time he walked by her room after helping her back to bed. By the end of the shift I was about to head towards respiratory distress because I couldn't stop laughing! Gotta love our jobs :)

911RN said...

We call our ER the "Fish Bowl." The design is a center, oval central station-charge nurse/ secretary at one end, nurses in the middle and docs at the other end with all the rooms around the "race track" oval.Try as we might to keep curtains closed and glass doors closed- often feel people watching and listening to us like fish in a bowl!

Like Maha- had a severly manic much older women that fell in love with one of our docs and kept hollaring out, "Oh, Cabana Boy!" all night to him! He was red to his ears til morning and I needed a Depends! Only in an ER.

Great story, glad you recovered from your soap/gel allergic reaction and Mrs. K was not a Hoochy Mama, after all. Sweet ending- reminding you of your spirited Grandma. Keep up the great stories!

SeaSpray said...
This comment has been removed by the author.
Jade said...

Great story!!!

SeaSpray said...
This comment has been removed by the author.
SeaSpray said...

Ah...a man after my own little germaphobe heart! ;) I don't blame you. :)

I found myself staring at my doctor once post-op back in SDS. I didn't even realize I was doing it for awhile... and then it hit me.

"promiscuous hussie in her youth" You never know. :) I used to wonder about the pasts of all the elderly people in the nursing home that I encountered when I went in to visit Mom.

I felt in a fishbowl in registration. It's funny how we adapt ..not making a lot of eye contact as we work as if they aren't there unless interacting with them. you go into a different mode.

"A screaming dementia patient can ebb away at your last thread of sanity in the middle of a crazy shift." So true and when said dementia patient is screaming ..NONSTOP every 3 seconds and you-the patient desperately need to sleep.

Conversely ..staff needs to remember they are within earshot and be careful what they discuss something isn't misconstrued in the patients mind ..possibly alarming or offending them needlessly. I've seen it happen at work and experienced it as a patient.

Oh ..maybe try citrus as a deodorizer. I think it cuts through those little odor particles in the air.. not sure tho.

t. said...

Hahaha!! I'm not sure if "gross" or "funny" would be the apt description for this story!

Maybe a but of both... despite how gross bodily functions are, they make for funny stories.

littlepretendnurse said...

I am almost in tears as I read this story. Reminds me somewhat of one of my fav stories from the nite shift. Again one little old lady with dementia and a nice sweet male staff member! Loved reading this one. Thanks for sharing.