Friday, January 29, 2010

You're hurting my penis!

Last night, I was babysitting a one-to-one who was a 93-year-old, confused, nearly deaf old guy. He was really very cute, but he had to have a foley put in and just couldn't understand why the hell a tube would be in there. All night, he kept scrunching around in the bed and trying to fiddle with it. I let him play with it a little, because he would get very agitated if you tried to stop him, but when he went to give a great big yank, I grabbed his hands and had to pry it out of his grip. He started trying to punch and kick me. While I was avoiding the blows, a male nurse came in (no doubt attracted to the noise) and went, "John! What's the matter?"

The old guy sits straight up in bed, rips off the sheet, points to his VERY exposed junk and exclaims "She's hurting my penis!"

I had to try so hard to keep a straight face while the nurse explained (yet again) what a catheter was.

"I don't care!" the patient kept saying, "That girl's dangerous. She's hurting my penis! She should be in jail!"

Wednesday, January 27, 2010

How to...not annoy your nurse's aide (as the patient)

I think that this post will be the first in a how-to series. Much like the patient profiles, you can expect one of these every now and then (aka, whenever I come up with one).

1. Don't ring the call bell more than once every hour and a half to two hours- unless it's for something urgent.

If you're a heavy call bell ringer (something we've discussed), I, the nurse's aide, won't come check on you at random. You know why? Because I know you'll be ringing that damn bell soon anyway, so what's the point of stopping in yet again?

To get on my good side, ring the bell infrequently for things like water, gingerale, cover-straightening, etc. I'm doing rounds. I'll come by to check on you for those things anyway. There's NO NEED TO RING THE CALL BELL ABOUT THEM.

Things that qualify as urgent, for which you should definitely ring the bell: chest pain, heart-racing, and bathroom/bedpan requests. Nothing else.

If you dropped something- do you really need it now? Right this second? Can it wait twenty more minutes til I come in by my own volition? At least consider it.

2. Keep the room parties to a minimum.

We love it when your family stops by. There's nothing better than some reassuring company in the hospital so that you won't break down crying later because you're eighty-nine and nobody who's alive cares, boohoo. The thing is... when you're sharing a room with someone else and have more than four other fussy, doting people in it at one time, there's a danger of overcrowding. An inevitable danger, I should say. The average hospital room size is smaller than a college dormroom, and you're STILL SHARING IT with a roommate.

Please. Limit the partying, and make sure those visitors don't stay past eight. You're in the hospital because you're sick. Sick people should go to bed early, or at least let their roommates do so.

3. Understand my job position.

I am not the nurse. I am the aide of the nurse's position. I do the grunt work, and I'm cool with it.
Therefore, do NOT ask me to explain the effects of Coumadin, or why your doctor took you off this medication or increased your dosage on that one. A nurse's aide's basic mantra is the following: 

I have no fucking idea; I just work here.

Most likely, I don't have my associate's degree yet, let alone my bachelor's. I'm measuring pee, scooping poop for stool samples, and fetching you water to get the experience and cash to go to school so that I can learn the answers to your questions. You asking me these questions is just rubbing salt in the wound.

Even if I know the answer to something medical, I'm legally not allowed to answer it. Nor can I change your diet order to be a hamburger rather than some awful shit they made "mechanical soft." It's not my fault that the doctors think you can't chew regular food, even though you probably can't, seeing as you left your dentures back at the nursing home, and it's hard to understand you through those flapping gums. You need to realize that nurse's aides have little say in anything that goes on in a patient's hospital stay. Do us both a favor, and don't bitch me out. It's incredibly counterproductive. Once you bitch me out, do you think I'm going to answer your call bell more promptly, or less?

4. Get your family to bring in food. 

Not kidding. Either go the chocolate or fruit route. Chocolate, we'll love you. Fruit, we'll love you even more because our entire diet consists of chocolate items donated by patients' families. Whichever option you choose, make sure the box or basket has a card that declares, in large print, your name, room number, and bed position (door or window, also known as bed 1 or bed 2, respectively)

Extra props go to you if you have your family bring in a large crockpot meal and place it in the nurse's lounge. Make sure to supply bowels and spoons. If you can't get out of bed to do it yourself, have your family declare "Dinnertime, on us!" and begin enthusiastically spooning out portions into bowels, church poverty program-style.

 We won't forget it. And your bell will be answered in fewer than ten seconds, or however long it takes us to bolt from the opposite edge of the floor. Seriously.

5. Send a final I'm-better present.

When you leave the hospital, don't make that the end of your stay. Send some (more) food, and include a card with it that thanks every person who took care of you. Accomplish this by asking every hospital worker who comes in the room to write down their name. That way, when you leave, you'll know who was there even if you were too sick to remember.
If someone, nurse's aide or otherwise, went especially out of their way to help you out, whether by spending time talking with you, or comforting you, or even running down to the vending machine to get a candybar for you, make that person his or her own card. Write a special message inside, and sign your name.

Every aide I've known to get a card like that treasures it. Those are the ones we pull out of our lockers on bad days to read over and over again. It reminds us why we do our job- not necessarily for the money (though that helps), or the experience (though that's what really helps in the longterm), but for the people we meet. 

Remember- nurse's aides don't make tips. The least you can do is make them feel appreciated.

Tuesday, January 26, 2010

Hard Day's Night

Last night was atrocious. It would have been manageable... had the patient census not unexpectedly swelled to forty-two, from a lowly fifteen two nights before. Oh, and we had two suicidal patients who needed to be babysat and couldn't be placed together.

Luckily, two aides from day shift volunteered to stay until 1900 with the suicides. That left me and Arthur (another aide) on the floor. For forty-two patients. That's twenty-two apiece. That is fucking ridiculous.

As soon as we saw the census, he and I went up to Catherine (charge nurse) and were like, "Yo. We claim the one-to-one's at 1900 when they leave." Then we went to work.

On those kind of nights, I don't feel overwhelmed. I get this strange sense of peace, like the one I'd imagine I'd get if I had just been shot and knew I was dying. Since there's nothing you can do about it, you might as well sit back and relax. No sense in worrying. Just keep on trekking.

The most important things to do between 1500 and 1700 are vital signs, blood sugars, and setting people up for dinner. It would be impossible to do all these things for twenty-two people in two hours. I work on a telemetry unit, keep in mind, so our average patient age is about 80. Sometimes higher. Probably 4 out of 10 patients can go to the bathroom by themselves, and about the same amount can set themselves up for dinner.

So, you know, these are the kind of nights that I expect nurses to do a little bit for themselves. Not much. I go up to them and make a deal- I'll do either vital signs or blood sugars on your patients. Which would you like to do? And do you know what my nurses did last night? Fucking nothing.

"Oh, I can't do that. I'm behind on my charting."

"Oh, sorry. I have a patient whose blood pressure is high as the sky, so I can't really take my attention away from him."

"Oh... well. You can do them still, because if they're a little late, that's all right."

Bitch, it better be all right.

All in all, I got twelve vital signs in the first hour, which is a stellar record, considering the number of bells that were going off. Between 1600 and dinner time, I took eleven blood sugars. Eleven! And not one, not two, but THREE nurses asked me "Where are my sugars?" around 1615. I hate it so much when they can't even take five minutes to get their own sugars. What took me twenty-five minutes would be about five or six minutes work between all of them.

After that, I managed to set everyone up for dinner just as the trays were being delivered, and I took my last couple of vital signs around 1830. PHEW. Then I took my dinner into one of the suicidal guys' rooms at 1900, stuffed my face, and watched TV with him until 2300. Both the supervisor and a staffer came in and begged me to stay the night, or at least until 0300. "We'll give you a bonus!"

Shiiiiiiiit. If they were offering me a McMansion and the key to eternal life, I wouldn't have stayed. I'm not looking forward to going back in tonight. Maybe they'll cancel me?

(HAHAHAHA, that last part was a joke.)

Monday, January 25, 2010

Patient Type: The Bell-Ringer

Every now and then, though usually on your busiest of days, you have that this one patient type we'll call "the bell-ringer". 

Stereotype Characteristics:

- Patient rings his call bell at least four times an hour, often more.
- Three out of those four times, it's for bullshit like fluffing pillows or adjusting bed covers. 
- When you enter the room, he says "Oh! There you are." Like it's a coincidence that you just happened to show up, rather than the blaring bell ringing throughout the floor. 
- You are thanked profusely after everything, so you can't justify hating him.
- As you back the hell out of the room, you say, "Is there anything else I can do for you while I'm right here?". He says, "No, but if I think of anything, I'll ring!" A comment sits on the tip of your tongue, straining to escape your lips, but you don't let it, because it goes something like this, "Bitch, stop thinking! Just go to sleep or watch TV already!"
- Patient grows frustrated if you do not immediately drop everything you are doing to respond to his call bell.

Typical Results:
a. your response times to their bell grow progressively longer, and when questioned, you mention how, since you were just there, your other patients' bells have priority. 
b. you set up 'busy' tasks for the patient, not limited to but most definitely including: television, magazines, family (by phone or personal appearance), puzzle books, newspapers... 
c. you sit down and have a talk with the patient about how the call bell system works. Sometimes, this works, especially if you promise to stop in every thirty minutes guaranteed, as long as he refrains from ringing his bell more than once an hour. 
d. you bug the nurse for some Ativan, stat. 

Degree of Difficulty:

Like riding a bike- you may not get a bell-ringer for a while, but once he's back, muscle memory kicks in.


Hello. My name is Audrey Morgan, and I wipe ass for a living.

(I've always kind of pictured that as the type of thing you could squeeze into the box of a 'My name is' sticker.)

Okay, here's me being serious for a minute. I'm a 21-year-old nurse's aide at a small, community hospital. I've been a nurse's aide for ten months now and love my job. You should know, though- I've always been a sarcastic person with a strange sense of humor. My current job position has only amplified that quality.

I was thinking the other day, while I scooped up a stool sample and bagged it:

There are plenty of blogs written by doctors and nurses. (I myself read Nursing Student Chronicles, a blog I may be echoing when I enter Jefferson University as a nursing student this upcoming fall.) Many people read these accounts and marvel at the stories such wondrous people experience. Oh, this doctor comforted a patient dying of cancer. Oh, this nurse was touched by a life lesson from an elderly woman who desired death above all else. 

And, in all temporary seriousness, these blogs are inspiring to read.

There's just one thing left out: the nurse's aide.

Hi. I'm the nurse's aide. You know, the one who helped you onto the bedside commode when you were too weak to stand. The one who fetched you a fresh glass of ice water and searched the hospital high and low for chocolate ice cream and graham crackers. The one who wiped your butt when you messed and reassured you that accidents happen.

Oh, you thought I was the nurse? It's a common mistake.

My goal in writing this blog is not to anger anyone, nor to completely belittle nurses. The average nurse is knowledgeable and helpful, and many are willing to teach and explain their actions. Then again, there are also many who are stupid, lazy, and incompetent, and ninety percent of the patient's care is left up to who?  Yup- yours truly.

I want to reestablish the nursing assistant, aka the patient care tech, aka the nurse's aide back into common knowledge. We're often forgotten to be mentioned, seeing as we're at the bottom of the medical food chain, but one thing is for certain- we make an impact on patients that many times outlasts that of the nurse's.

Look for updates four to five times per week. I hope you enjoy the following true accounts.