Ah, spring is in the air. Flowers are blooming, the weather is balmy, the dogs get to romp at the park every afternoon, and work seems to have let up slightly. (Uh oh, did I just jinx it?) All of us are raising our weary heads and looking around a little bit. Even the Powers That Be seem to have taken note of my personal ennui (perhaps because I dropped a few hints about getting called for an interview at another hospital) and have stopped putting me out in triage and in charge every day. So I'm taking care of actual sick people. Oh, right, THAT'S why I became a nurse.
Poor Disappearing John, usually the bright light of good feelings and optimism in the face of annoying patients seems to have had a bad day.
And in contrast, I seem to be having several nice patient-care episodes in a row:
The sweet elderly gal with the dislocated shoulder: she was in so much pain, and her niece was so upset for her and concerned. The patient kept saying, "That doctor isn't going to touch me while I'm in so much pain, is he?" We knocked her out for a minute with a little etomidate, and then her shoulder just eased right back in. She woke up ten minutes later, saying, "When are you going to start?" I asked her, "How's your shoulder?" She replied, "Oh, it doesn't hurt at all! What happened!" I assured her she was all fixed, and as soon as she could drink a little water and walk to the bathroom, that she would go home. "It's a MIRACLE!" she said.
Another elderly gal, this one slightly demented and very anxious, sent in for a possible CHF exacerbation. Legs grossly swollen, but not a lot of fluid in her lungs. Was refusing to let anyone come near her--and would not take off her nonrebreather mask. I really wanted to get her on some nasal cannula, get a Foley catheter in, and get her some Lasix. All of which she was refusing. Then she said (in a high-pitched bird voice) "But I'm SO HUNGRY and I'm DIABETIC WHAT WILL I DOOOOOOOOOO?!?" So I traded her nonrebreather for a grilled cheese sandwich and nasal cannula and stuck in a Foley while she was busy eating it. She barely noticed. (she must have been REALLY hungry...) I left her sitting up in bed, cheese smeared on her face, munching away, like some sandwich-eating bird in a nest.
And probably most satisfying: A very distraught woman comes screeching up the ambulance ramp; security gets her mother in a wheelchair and wheels her into the ED. The woman is gray and limp. No palpable pulse. In seconds she's in a bed; in another minute, we're shocking her v-tach and giving meds and chest compressions, intubating. A central line is in, more meds, another shock, and...nice strong pulse back. Heart block on the monitor and on the EKG, but perfusing well and trying to breathe on her own. Within forty minutes of arrival, the patient goes upstairs to the CCU. AND--even better: When I went to inform my other patients that we'd had an emergency that tied up the docs, sorry for the delays, thanks for being so patient, all of them said of course, we understand, no problem.
I don't think I ever had more than five or six patients at a time in the last few days. Made me feel like a real nurse, able to care for my patients and talk to them, do full assessments, bring a pillow and a sandwich, anticipate their needs and make them feel better.