sometimes, my head explodes

the usual chaos October 26, 2007

Filed under: on work — somniare @ 7:45 am

What I see day in and day out is typically enough to turn the stomachs of the strongest individuals.

Last night, once again the floor was hideously understaffed. I was split between working at the desk for the first 4 hours, going to a conference regarding the development of the hospital, then the remainder of my shift picking up a patient assignment on the floor. This was how things were supposed to work.

We had already had a deranged veteran on the floor who needed one to one supervision. This means that the hospital was supposed to designate someone from the nursing office to come and sit with the patient due to them having needs that were beyond the nursing staff on the floor to be able to accommodate on top of being able to take care of the rest of those on their assignment. This usually pertains to patients who are at risk for climbing out of bed, confused, ripping out their IVs or other medical devices, etc. and require someone to sit with them 24 hours a day to make sure they don’t hurt themselves in their mania. In the first hour of the shift, we received another patient in a state of dementia. Because the nursing office had already decided to leave the unit stranded without any help, someone had already been pulled from the floor to sit with the crazy veteran who screamed at everyone in military terms and then had to find someone else to sit with the new woman. That lucky person… me.

So I’m walking in (following the screams to find the correct room) and am greeted by 5 pairs of exasperated eyes as they were struggling to turn her to change the linens underneath her. She’s howling on and on, “This is TERRIBLE, I feel AWFUL!!!” But her favorite phrase was, “This is just ROTTEN, I feel ROTTEN.” This poor little woman in a state of complete degradation… she had to be the oldest person alive. Shame on me… all I could think about was, “Oh lord, if I ever get to this point where I don’t even realize that I have lost my dignity, please just remove me from the planet with swiftness.” I will spare you the gory details as to WHY this poor woman was brought to the hospital as the visual I’d create for you is one that would cause sleeplessness for years to come… well as an inability to every eat a grapefruit… yeah, you don’t want to know.

When the commotion was finished, I sat on the windowsill next to her bed as there was no chair for me and no one would take the time to bring me one. I sat and talked to her. She glanced at me with looks of disdain every now and then but refused to be baited into conversation. As she sat there looking away from me, I decided a different tactic was in order. I looked at her hunched shoulders as she struggled to get comfortable in thought with her head bent at such a crooked angle. Her arms were covered in goosebumps from having been recently stripped and exposed to the cold, dry air. She wouldn’t drink the lovely concoction otherwise known as a bowel prep that I was lucky enough to have to give her. So I walked up to the side of the bed, lowered the head a bit, pulled the pillow to the side so that her head would stop rolling off of it and put an extra blanket around her shoulders. I stepped back and she looked up at me with the clearest blue eyes, lucid and aware she said, “You are lovely. That is so much better. God bless you.” From there on out, she would listen to no one BUT me, she wouldn’t so much as look at anyone else. When the nursing office finally sent someone to relieve me, I said goodbye.

Later in the evening, I had to head off to the ridiculous conference regarding all of the new plans for the hospital. “Crucial Conversations” they call them. I had been to the first round of these talks and dreaded walking into this one. I am not shy about speaking up in these. I am no public speaker but for some reason, I feel the need to speak up for myself and those that have suffered with me for years on my struggling unit. I brought up a few points that got the entire room riled up and the conference ended up lasting nearly two hours throwing me way back in my work by the time I got back to the floor.

I walk back up to the unit and was met with what could be described only as pure chaos. They had blocked off multiple sections of the floor due to having to wax the floor so the halls were absolutely crammed with stretchers, equipment, linen and supply carts and employees weaving in and out like pedestrians during rush hour in NYC. The call lights above the patient’s rooms were lit up and down the halls like seizure inducing beacons. I was immediately assaulted by 3 or 4 people telling me about various things that needed my attention, “Go help them with the patient that was dropped off in 67… they didn’t even call report and the room wasn’t even clean yet, they are just sitting in the hall and no one knew they were coming!!” “The only aide scheduled to come in on the night shift called in! There’s no one to do midnight vital signs!” “There’s a stat blood draw in 58! Go get the bucket!” “I need a pre-op EKG in 76!” The list went on and on and my head just spun as I stood in the middle of this apocalypse. The last bit of news was the icing on the cake. The one to one from the nursing office had to leave at 9, you have to go sit with 54. Well, alright then… at least that saved me from all of the needy bastards that had the balls to launch a million things at me within seconds of returning to the floor.

I walked back in to the little old woman’s room. Sit back up on the window sill and look at her. She’d reverted to her epic pouting, sitting with her arms crossed, picking at her blanket in misery and wouldn’t so much as look at me. I sat quietly on the sill for about an hour. I decided to risk speaking with her again. She looks over at me, not quite lucid any longer but her emotions were sparked. She goes off on a barely coherent tangent about being degraded and how everyone is out for themselves. She was waving her arms in disgust at how the doctors and nurses are all out for themselves to merely get ahead in the world. Her treatment wasn’t about here any more, it was about a mission to boost egos and look better on paper. For some reason, I understood. I asked her if she had any children in an effort to steer the talk a different direction. It worked. She had one son whom she seemed to think the world of. “He’s a good boy… such a good boy.” She repeated this sentiment in various forms for a good half hour before she tired herself out. She spent the next 15 minutes contentedly staring at me when she thought I wasn’t looking. When the time came for me to leave as the relief for the night shift, I reported off to the nurse and stepped back up to the bedside. She reached out and took my hand and a smile lit her face in a way I would never thought imaginable. Youth and vitality just radiated. As I held her hand she says to me, completely coherent, “I have had my day and I want to enjoy the rest of my days. I will live through this as I have lived through everything else. You have been absolutely wonderful. Thank you so much for taking such good care of me when everyone else just left.” I would be lying if I said I wasn’t touched. I made a difference to someone. Whether she remembers me is not important, I will remember her.

I walked out and proceeded to help out with the midnight vitals for the next shift. I did my patient assignment (whom I never actually got to see over the course of the evening) and then helped out a bit extra. I got out 15 minutes late and my head and chest were killing me from breathing the fumes from the floor wax. I was untouched by it all though. I looked around at all of the miserable faces and felt a small little burning of hope for them all and the future of this unit 2800. I haven’t felt anything in months working there. Nights like this… well, they put life in perspective. Put my purpose into plain view. I am here, on this world, in this job, doing what I do for a reason. I slept like a baby that night.

I love my job.


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