Who invented the call bell?

Pretend like before each minute marked, the call bell goes off and a nurse goes in and asks the patient what s/he can do to help him.

2127: "Before I go to sleep, can we rub some lotion on the back of my left shoulder? It feels a bit dry."

2136: "Can you scratch my nose?"

2138: "My nose still itches."

2144: "Can you scratch my forehead? The itch has moved from my nose to my forehead."

2147: "We should probably put lotion on my forehead now."

2155: "Am I dying?"

2158: "Does my gown need to touch me? I'd prefer it not touch me."

2204: "It's my eyelids now. They need lotion. Do you think we should just put lotion on my whole face?"

2209: "What if we call my wife, and she brings some rubbing alcohol in... Can she put rubbing alcohol on my face and back?"

2220: "I was just making sure you guys were still out there."

2230: "Do you think maybe we can clip my toenails tomorrow?"

2235: "Are you sure I'm not dying?"

2238: "How many types of blankets do you guys have? I don't know if I like this one."

It went on all night. With a break between about 2330 and 0155 and then again between 0330 and 0430. You'd think the sleep would help. It didn't.

Inappropriate

So Georgia, perhaps the sweetest and most innocent nurse I know, was taking care of Mr. B last night. He'd been in our unit for awhile with his infection secondary to IV drug abuse (clean needles people!) and his ensuing sepsis. We all had been taking turns falling on the proverbial sword because he was generally just a surly, rude and unfriendly guy. So last night was Georgia's turn.

They had an uneventful night, probably because Georgia is so nice and catered to his every whim. In the morning, she was helping him get up to the chair and he reached towards her chest. She thought he wanted to see her name on her ID and pulled it out to show him. Wrong.

Mr. B: "I don't want to see that."

Georgia: "Oh, ok, what do you want to see?"

Mr. B: "I'm trying to touch your titties."

Georgia, gets all flustered: "Mr. B! You can't do that!"

Mr. B: "I can do whatever the fuck I want. It's your job to make sure I'm happy. Get over here and let me touch them. I haven't gotten any since I've been stuck in here." 

Luckily, she left the room then. She was visible shaken and disturbed when she came and told me. She said that he asked her to bathe him next and that she wanted to say no. I of course told her not to do so. In fact, I didn't let her go back in for the rest of her shift. We assigned boys to that patient for the duration of his stay with us. Female employees who had to care for him used the buddy system while in his room. (This didn't stop him from repeatedly displaying his penis to said female employees on multiple occasions.) We told the story up the hierarchy to our manager and patient rep and nursing supervisor. But nothing came of it. He denied his behavior so it was "his word against hers." Classy. Clearly, we always want to err on the side of being warm and fuzzy to the patient. Way to stand up for the employees.

Now I realize I've previously posted a "funny story" about a delirious old guy commenting on my boobs. Double standard. So shoot me. It's a whole different ball game when the comments are coming from a 80-something year old, totally delirious and confused old man and a 40-something year old who's completely with it and has been an ass throughout his whole stay. Both are inappropriate, but there are gradations.

Are there any other professional scenarios outside of healthcare where the mentality is just "grin and bear it?" "It's not really their fault..." Consequences are just so rare for patients who abuse caregivers. In any other work-related scenario I can think of, the perpetrator has some sort of negative consequence. You look sidewise at a flight attendant and you risk getting thrown off that plane. Reach for a bartender's breasts and a bouncer will quickly be forcing you to get your drinks elsewhere. Most places of business reserve the right to refuse service to anyone. Our corporate institutions have lengthy sexual harassment policies. But healthcare providers can't kick someone out of the hospital. We are obliged to continue to care for the patient.

In my short years of being a nurse I've had a knife pulled on me, had a patient break my wrist, been thrown to the ground and strangled, endured more references to my breasts than I can remember and can't even count the number of pinches, scratches, bruises and bumps patients have doled out.

Now I know what you're going to say. I should have made a big deal out of some of these situations. And I'm sure I could have. In some circumstances, I considered the patient's disease at fault, not the patient themselves. (Except for the time my wrist was broken. I considered that to solely be the physicians' fault. Another story....) That's the overwhelming thought I believe. And one I support in some circumstances. But why do people think, in ANY circumstances, that hurting or harassing a caregiver is an appropriate response? Being scared and sick is terrible. But it's not an excuse to abuse me.

Tip of the night: fake IDs

So imagine you're a nice 20 year old gentleman. And you just went to a fratastic party with you bros. And somehow, you end up separated from your bros. You just might think that the sidewalk looks pretty comfy and decide to sit down and take a nap up against a fence. Logical choice, but unfortunately, that makes passers-by worry about you and call 911. And then I show up. And a lovely police officer as well. Lucky you.

Now I've been doing this awhile and let me tell you, the officer really doesn't care that you're drunk. She has to run your ID in case you're wanted for murder in Arizona or something, but really she doesn't care. Unless you do something dumb that makes her have to care. And therein lies my patient's problem.

Officer: "Can I see your ID?"

Drunky McWasteface: hands over student ID (which has no birthday on it coincidentally)

Officer: "Great, thanks. How bout a driver's license?"

DMW: ponders this as he flips through his wallet. Hands over an out of state driver's license.

At this point, I glance down, mostly out of curiosity over the pretty, colorful out of state license. Then I come to the same conclusion the cop did. The IDs don't match. The brilliant young man gave her his REAL student ID and told her that was his name. And then gave her his FAKE ID with a totally different name on it.


Smart move dude. You just basically tied her hands to a pen and a ticket pad. You MADE her write you a ticket. She didn't want to get you in trouble. You begged for it.

Next time here's what you do...

1) Pretend you have no ID. She's not going to search you.
2) Claim you only have your student ID.
3) Give her your real driver's license. She really doesn't care that you're underage. Do you think she's an idiot? She's a cop in a college town.
4) Don't get drunk and sleep on the sidewalk, necessitating this entire interaction.
5) Actually pull off your fake. Rock it. McLovin did it.

All are viable options (except #5... don't try #5 with a real police officer). I'd really prefer you go with #4 though. Thanks! <3, A

I confuse the ambulance with a taxi too

So we get dispatched to one of the libraries on one of the college campuses in town. Call was for an 18 year old female with abdominal pain. As we arrive on scene, pulling up on the sidewalk in front of the library I noticed a young blonde girl skipping down the front stairs. She caught my eye because I feel like people rarely look happy and carefree at the library...

I get out of the truck and walk around gathering my jump bag and such to walk into the library in search of our patient. But then, much to my surprise, said blonde girl came around the side of the ambulance and scampered up into the back, settling in the captain chair in the back.

A: "Um, hi? Did you call us?"

Girl: "Yea I sure did!"

A: "Oh well ok... what's going on?"

Girl: "I have cramps. I don't feel like studying anymore."

A: "So you want to go to the ER...?"

Girl: "No! Why would I want to go to the ER just for my period? Just take me home... I'm done studying for the day."

A: blank stare "This is an ambulance. You called 911? We take sick people to the hospital."

Girl: "Oh well it's just a quick trip. I live in dorms just down the street. It won't take you very long."

Luckily the campus police walked up at this point and offered to take her home. I think the officer realized that if the conversation went on much longer she'd be investigating the patient's murder as I would have strangled her. Way more paperwork than just taking chickadee home.

Save the squirrels!!

Communications: "Truck 17 for the animal rescue, 293 Jefferson Ln."

Truck 17: "Truck 17 en route."

Communications: "Truck 17 you're en route to 293 Jefferson Ln for the animal rescue. Squirrel on a telephone pole."

This is when my ears perk up, and we decide it'd probably be worth it to mosey on over that way since we were just a few blocks away, on our way back from the hospital.

It gets even better...

Communications: "Truck 17 be advised, the caller reports that she's noticed a squirrel on top of the telephone pole outside her sorority house several days ago and that it won't come down. She's concerned about the animal's welfare."

How the dispatcher said that all without laughing and in a generally professional tone is beyond me.

The truck gets on scene and promptly clears the incident maybe 6 seconds after their arrival. We pull up 30 seconds later to all 4 guys off the truck, doubled over and crying they're laughing so hard.

The squirrel was obviously dead. Sorority girl, after being informed of this, told the truck's crew that they should get it down so she "didn't have to see the poor dead squirrel anymore." They responded with blank stares. 

Your tax dollars at work folks!

We say no for a reason

As I've mentioned before, the U operates on a lot of people that other hospitals wouldn't dream of operating on. Frequently, us nurses can be overheard questioning the sanity of our surgeons for approving this or that patient as an operative candidate. So when they do turn down a patient for being "too high risk," believe me when I say, that patient is so high risk that their chances of surviving surgery are negligible.

So the other day, there was this lady who was turned down for just such reasons. She absolutely did not qualify for a traditional surgery and was even deemed too high risk for our clinical trial alternative that is currently only enrolling high risk candidates. Her list of co-morbidities was not the longest I have ever seen, but they were significant and serious. She saw all of our surgeons and several related medical specialists who were consulted in her case. Everyone told her she would not survive the surgery, could not be optimized medically to be able to survive the surgery at a later date, and had no palliative surgical options.

This lady was adamant she was going to have surgery though. Not only did the U turn her down, but so did every other major medical center in several states. From what I have gathered, this lady was not used to being told no. With her family's connections and money, I assume few people have ever told her no for anything. Maybe that's a snarky assumption on my part. But it seems to be true.

So after being told she was not an operative candidate at a handful of top ranking medical centers by a myriad of well-respected physicians, what does she do? Go home with optimal medical therapy to spend the rest of her life (which was in danger of ending in the next year or two, but not imminently...) with her friends and family? Call hospice for assistance with symptom relief? Check out the swanky surgical digs in Mexico or Thailand? Nope.

This lady called the FDA and petitioned to get included in the trial. Like straight up told the FDA she should have surgery even though all the experts said she was not a candidate. The FDA is smart. They said no.

So what's next? Give up? Oh no. This lady is important remember. So she talked to her buddy the Senator (or Congressman or something...) and he petitioned the FDA for her. And somehow, this politician convinced the FDA that she should have surgery. (How does that even work?!)

So back on down to the U she comes. We do surgery.

And guess what? She fucking died. She didn't survive 24 hours out of surgery.

There are so many things wrong with this story. But mostly I keep coming back to... this is a prime example of why politics and medicine don't mix. The patient and the politician made this decision contrary to the advice of the people whose job is to be an expert in this subject matter!

Furthermore, their reckless arrogance has now not only affected this woman and her family who could have spent more quality time with her, but also potentially screwed the results of a major clinical trial.

Angry face.

Where do we find these people?

The U does a lot of surgeries that the other hospitals in a rather large area wouldn't touch with a ten foot pole. It's good and bad. We give hope and frequently, success and positive outcomes to people who get turned down by everyone else. At the same time, sometime we give a bit too much hope I think. Some people just aren't operative candidates. Or even if they are, albeit incredibly high risk candidates, the more humane thing to do would be not to operate.

It leaves us wondering where our surgeons find some of their patients. For real... I literally have no idea how they find some of these people.

Like Friday, when one of our surgeons operated on this lovely gentleman. A redo-redo surgery. Oh and he's a hemophiliac, with end-stage liver failure. Who's an inmate in the middle of serving a 10 year sentence.

I couldn't come up with a worse candidate (medically and socially) for open heart surgery if I tried. You can't make this shit up.

Maybe the surgeons troll the prisons, looking for a challenge? Got to keep them on their toes.