I hate those 1-to-1s sometimes...

I babysit a 69-year-old with Alzheimer's tonight who tested my patience to the extreme. The highlight was when she spit a mixture of applesauce and pills directly into my face. : /

Good part is, I got a lot of great quotes from her!


Henrietta: "Give me back my liver!"


Henrietta: "Look at my pretty bottom..."
 

Henrietta: "Can you reach my pumpkin? Or am I going to have to do it for you?"

For the Disturbed

85-year-old Patient admitted for 'Change of Mental Status': "Help! Help me! I don't know where my husband is! He isn't here with me at home, and I don't know where-"

Me: "Do you know where you are, dear?"

Patient: "Of course I do."

Me: "Tell me where you are."

Patient: "I'm... I think I'm in a place for the disturbed."

Me: (bursts out laughing)

Other Aide: "Oh, she has no idea..."

Shuffle Shuffle

Me: "You're funny, huh?"

89-year-old Patient: "Oh, I'm not just funny, honey, I'm hilarious. My friends would say, 'Marlyn, you're a card.' And do you know what I would say? I would say, 'No sir, I'm not just a card, I'm a whole deck, and you should take care how you shuffle me!'"


Our hospital is loaded up to full capacity right now, so they brought in a tray of pretzels for the staff tonight. We descended on it like vultures on a carcass. I love it when they deliver guilt pretzels. Guilt pretzels are the BEST!

Ohohohoho!

Had a horrible, horrible night that ended where me and one other aide were on the floor. Each of us had 20 or so patients apiece and a huge percentage were incontinent.

We set a goddamn record: Ten diaper changes, three of them necessitating a complete bed strip-down, in one hour and fifteen minutes. Beat that!

Plus, this:


Elderly Insane Female Patient, as we pull back her diaper to get her cleaned up: 

"Ohohohoho, cover my balls up!"

That's Why!

Sorry for the absence! I've been sick as a dog.

Or one of my patients...

Patient: "I'm a drinker!"

Me: "Why do you drink?"

Patient: "Because I have leukemia and I'm Irish, that's why!"

The Final Defecation

We need some background to this quote. I was taking care of a 98-year-old man yesterday who was firmly determined to die. Not only that, he kept telling me, "Today will be the day. I am going to die. I can feel it." It was freaking me out a little. I felt much better by the time I left because, of course, he hadn't died. We had quite a few nonsensical conversations about life, but the following is the best.


My 98-year-old Patient, sitting on the commode: "This is it. I can feel it. Here it comes."

Me: "Here comes what, Sam?"

Patient: "...I am having the final defecation." (strains like he's having a baby instead of a bowel movement)

Corn, I ask you?

Me: (creeps into a patient's room to try to empty his catheter without waking him)

Patient: (drowsily) "What are you doing down there... are you- are you pulling corn?"

Patient Type: the Paralyzed Patient

You hear a patient yelling "Help! Help!". Naturally, you walk in and say, "Can I help you? Why didn't you ring the bell?"

And they go, "I'm paralyzed from the neck down."

Right about there is the point where you feel like a douche.

Stereotype Characteristics:
- Patient requires constant readjusting and has a "system" for it. For example, you start out by straightening their hips, and then you fix up their legs, then their feet, then you arrange their hands in their lap and on and on.
- The bell rings every five minutes for things like "Could you push the water cup three centimeters closer so my lips can reach it?"
- There are constant moisturizer requests. It's like they have nothing else to think about. You will be moisturizing their face, feet, and butt, along with putting chapstick on therr lips.
- Every now and then, one of the patient's bells will be answered by another aide before you can get there. He or she walks out a half hour later vowing never to help you out with call bells again.
- Patient drinks/eats only organic items because it's "healthier." You feel like asking, "What's the point?" since the patient is in renal failure, liver failure, and oh, BY THE WAY, is paralyzed and can't move this "healthy" body anyway.
- Meal times are a nightmare, involving multiple towels, spoons, and extremely slow feeding. Forget about getting anything else done.

Typical Results: 
a. You begin to delay or ignore their bell and think of it as ambient background noise.
b. When they ask you to adjust something, you do it crappily so that the next time they see you, they'll settle for a mediocre fix instead of perfection.
c. You ask the unsuspecting nurse if she can provide pm care while in the room with the paralyzed patient if you promise to do all the rest. She happily agrees. You dodge away before she can realize her mistake.

Degree of Difficulty
 Definite hard mode. While you may be incredibly pissed that they ask for the eighth time in one hour for you to readjust something they can't even feel, you can't show it. Besides that, you feel guilty for feeling it. For shit's sake, this human being can't move from the neck down. That's terrible. You know what's even more terrible? Giving in to rub lotion onto their corn-encrusted feet in a half-hour foot massage while your other thirteen patients are completely ignored.

In conclusion, paralyzed patients are never good unless they are your only patient.

Pink Elephants

Me: (after taking a 190/114 blood pressure) "Oh, wow. Do you usually run this high?"

Patient: "No, I'm not high. Though this one time, back in 1967, I did some crazy shit. Seriously crazy. I saw pink elephants. You've never seen pink elephants until you've done the shit that I did. Have you ever seen pink elephants?"

Me: "... no. But I said that your blood pressure is high. Do you have a history of high blood pressure?"

Patient: "Oh! Oh. Yes, I do." (laughs nervously)


(headdesk)

Mock Schedule

Yesterday, my charge nurse asked me to create a nurse's aide schedule for the 3 to 11 shift that they could use to teach new hires. I made up a simple one that turned out really boring. It was all, "Vital signs between 1500 and 1600, blood sugars at 1600, set up patients for dinner at 1700" and etc. Basically Yawn McYawn, hailing from the town of Yawnsville in the country of Yawn. I couldn't stand it. It wasn't even true.

That's when it hit me.

It wasn't even true.

Here is my real schedule... enjoy.


2:45pm: Arrive in the break room. Deposit dinner in fridge. Query the previous shift on whether it was a good day or a bad day.
2:50pm: Help self to a cup of water and write name on it. There won’t be time to hydrate once the shift starts.
2:55pm: Accept assignment from the charge nurse. Fill out patient sheet with information.
3:05pm: Search frantically for free blood pressure machines so that blood pressures won’t have to be done manually. Curse Aide #2 and #3, who have commandeered the good ones.
3:10pm: Begin taking vital signs on Patient #1 out of 10.
3:11pm: Call bell sounds. Answer it. Patient #4 asks for covers to be straightened.
3:20pm: Return to taking vital signs. Now on Patient #2 out of 10.
3:21pm: Call bell sounds. Answer it. Patient #8 would like a cup of ice. Fetch cup of ice.
3:40pm: Return to taking vital signs. Finish with Patient #3, #4, and #5 out of 10.
3:49pm: Call bell sounds. Ignore call bell and continue taking vital signs. Finish with Patient #6 out of 10.
4:01pm: Be accosted by Nurse #2 demanding to know why the 4pm blood sugars aren’t done.
4:10pm: Finish vital signs on Patient #7.
4:20pm: Finish vital signs on Patient #8.
4:30pm: Finish vital signs on Patient #9. Patient #9 needs her diaper changed.
4:50pm: Leave room scarred for life by the amount of diarrhea one elderly lady can produce. Give up on final vital signs and begin blood sugars.
4:51pm: Realize machine needs to have quality controls done because the night shift neglected to do it earlier.
4:55pm: Rush to complete blood sugars before dinner arrives.
5:06pm: Dinner arrives.
5:11pm: Last blood sugar is completed.
5:12pm: Interrupt Patient #10's dinner to take vital signs.
5:25pm: Note that five out of ten patients are incapable of sitting up for dinner and must be helped.
5:55pm: Finish setting up every patient for dinner. Pause to take a sip of water. Call bell sounds.
5:06pm: Answer call bell. Patient #8 has slid to the bottom of the bed and needs to be repositioned.
5:07pm: Search for Aide #2 to help in repositioning.
5:12pm: Learn that Aide #2 has taken a smoke break and is unavailable.
5:14pm: Request Nurse #3's help in repositioning.
5:15pm: Get denied by Nurse #3 because Aide #2 should help.
5:20pm: Find Nurse #4, who does not have Patient #8, but is willing to assist.
5:25pm: Finish repositioning patient and remove tray.
5:26pm: Round floor searching for dietary cart.
5:32pm: Assume that the cart has been removed.
5:40pm: Give up and go to place tray in Soiled Utility Room despite blatant sign.
5:42pm: Open door only to have it slam into the dietary cart three inches away. Drop tray and dump spaghetti over self.
5:45pm: Alert Martin (housekeeper) to the mess. Martin is not amused.
6:05pm: Return to floor in new scrubs. Rush to take a 6pm blood sugar.
6:15pm: Circle floor and update charts on ingestion and excretion, including meal percentages. Receive basic report from nurses on the patients that have been cared for, by you, for the past three hours.
6:30pm: Take dinner break. Get interrupted by nurses three times with requested tasks "for when you're finished".
7:00pm: Return to floor and check updated assignment. Nurse #2 has left, replaced by Nurse #3, and an aide has gone home sick. Pick up 4 additional patients for a total of 14.
7:10pm: Answer call bell. Patient #4 needs to be walked to the bathroom.
7:20pm: Answer call bell. Nurse #3 needs help coaxing Patient #9 back into bed.
7:32pm: Fetch bed alarm for Patient #9.
7:45pm: Assist Aide #2 in changing a 400 lb patient who does not bathe regularly.
8:15pm: Check blood pressure on Patient #1 to find it 65 over 30. Search for Nurse #3.
8:21pm: Fetch Nurse #3 to Patient #1.
8:25pm: Answer call bell. Patient #5 will be discharged and needs personal items packed.
8:27pm: Finish packing personal items.
8:50pm: Finish listening to Patient #5's stories about the war.
8:51pm: Begin 9pm blood sugars.
9:01pm: Get accosted by Nurse #3 demanding blood sugars.
9:18pm: Finish blood sugars.
9:21pm: Take a water break. Breathe.
9:24pm: Answer call bell. Patient #10 would like a snack.
9:30pm: Deliver snack. Patient #10 would also like a blanket.
9:36pm: Deliver blanket. In addition, Patient #10 would like help with the urinal.
9:45pm: Patient #10 requests marital status.
9:46pm: Patient #10 is denied.
10:07pm: All patients’ charts are updated, completed, and handed in to the charge nurse.
10:11pm: Patients are quiet. Nurses are busy. Lower self into chair.
10:12pm: Call bell sounds.
10:13pm: Answer call bell. Patient #6 requests Nurse #2.
10:15pm: Check desk for Nurse #2.
10:17pm: Check med room for Nurse #2.
10:19pm: Check supply room for Nurse #2.
10:22pm: Check hallways for Nurse #2.
10:23pm: Ask the desk if anyone has seen Nurse #2. Predictably, no one has.
10:24pm: Call bell sounds. Answer call bell for Patient #6, who demands to know where Nurse #2 is.
10:36pm: Discover Nurse #2 in break room. Inform her of Patient #6.
10:40pm: Empty catheter of Patient #2. Accidentally wake him and listen to him say he wants to die.
10:45pm: Comfort Patient #2 and reassure him that no, he does not. He argues and makes valid points you must not refute.
10:53pm: Back out of Patient #2's room, slowly.
10:59pm: Plop into chair in break room. Breathe sigh of relief. Respond incoherently when asked by next shift how the night went.
11:01pm: Call bell sounds. Call bell is ignored by both the departing and the arriving shifts.
11:02pm: Run like a bat out of hell!