Another elderly lady sent in from a nursing home for "no urine for three days, lethargy, and poor PO intake." When I went to assess her, there was someone at the bedside, who said she was "sent with the patient from the home." The patient was nonverbal, except to yell "LAWD LAWD LAWD JEEEEEEEZUS HELP ME LAWD" when you tried to move her around.
I asked the companion if she could tell me anything about the patient. "She sick, that's why they sent she to the hospital," was the response I got. Further questioning yielded no additional information.
I began wrestling with the patient to take her clothes off and get her into a gown. She was extremely strong, grabbing on to the side rails and pulling her arms and legs into her chest, latching on to my hands, and bawling "JEEEEEEZUS" into my face at regular intervals. I was sweating and huffing and puffing as the "attendant" sat in a bedside chair with her arms crossed, staring at me. "Her don't like she clothes taken off," she informed me.
"Ya think?" I said, blowing my damp, sweaty hair off my forehead. I managed to get the gown on, but by then she had grabbed the tubing of the IV the paramedics had started and was refusing to let go. As I tried to pry her fingers off of the tubing, trying to save the line, the attendant said, "You need to tie she down if she pull out the needle. Are they keeping she here tonight? I need to know if I can go home now."
Barely containing my anger, I said, "I'm not going to tie her down. As long as you're here, it's your job to make sure she doesn't pull out her IV. I don't know if she's going to be admitted, and I won't know until the doctor sees her. I'm going to call the nursing home and speak to your supervisor to tell her that you're going to be staying with the patient until she is admitted, IF she is."
The nursing home supervisor confirmed that the attendant had just come on shift and was to stay with the patient and help with her care until the patient was admitted or discharged back to the home. I inserted a Foley, cleaned the patient, started another IV and started fluids. I knew this woman would eventually be admitted for dehydration, but was in no hurry to inform the attendant of that. I knew she wouldn't do much for the patient, but I had no desire to grant this sullen, unhelpful, lazy person a night off.
I just don't understand why people think it's OK to take a job with clear responsibilities and then NOT DO IT. I guess there's something wrong with me.