The Making and Life of a Registered Nurse in the Era of COVID-19: Chapter Fifteen–My Nursing Stories

So, now that I have bored the reader immeasurably, let’s discuss a few of the anecdotal cases that every experienced nurse has. Patients are admitted to the hospital for all types of reasons. We, as healthy individuals take our basic body functions for granted, that is until they are not working any longer or in some cases, are working too well like diarrhea. Who would think that diarrhea could be life threatening but it can be. If you are loosing fluid too quickly to replace it, your electrolytes can become out of balance. Besides in many cases, diarrhea is also accompanied by nausea and vomiting, so you can get in trouble quite quickly. If your magnesium and potassium levels get out of balance your ability for your muscular system to work properly is brought into question. Don’t forget that your heart is just a specialized muscular pump. Now, the opposite can also become a problem though it takes the critical stages longer to manifest itself.

Finger painting.

The first hospital I worked at had a 50-bed locked down psychiatric unit. Well, if anybody knows anything about psychiatric nursing, it is that they chose that career path for a few reasons. I will leave it up to the reader to figure out what those reasons are. Suffice it to say, they are better off there than in an acute care environment. I will actually include a second story after this one that involves the same unit. In this particular story, the doctor wrote an order for the nursing staff to collect a stool sample from the patient. The collecting part was not the problem, it is what the nurse did with the sample afterwards that was the problem. She brought the cup with the specimen in it to the nurse’s station where she left it while she went to get a patient label. If you have ever been in a psychiatric unit, there is always some poor soul wandering around the nursing unit. Well, this one had a penchant for finger painting. What do you think he found but a wonderful ochre colored paint paste in a cup just sitting there calling his name. You would be surprised on how fast someone can finger paint. Before the nurse came back to collect her specimen cup, he had spread the “paint” all over the nursing station. What a glorious sight it must have been. By itself, this would not be a major problem because these units were made to be deep cleaned, so no harm no foul. You just had to deal with a very pissed off housekeeping staff. However, there was a reason the doctor ordered the test. Wait for it, wait for it, you guessed it, he suspected that the patient had C-diff. Well, guess what, he did. Not only did all 50 patients get C-diff but the entire staff did as well. What a shitty business that must have been. Good thing it was a closed unit.

Call a code blue.

Before patients can be placed in a psychiatric unit they have to be medically cleared. Once they are cleared, they can then be treated for their psychiatric issues. You may ask why this is the case? Well, you really don’t want these patients to have IV’s that they could pull out and bleed out from and cardiac monitoring cables that they could choke themselves with, so they have to be very stable medically. Since their hearts are not being monitored and they are left to their own devices for extended periods of time , there is no way to tell when a patient dies. But the rule is whenever a patient is found not breathing you have to call a code, unless they were previously made a DNR (do not resuscitate). In these units, vital signs are only checked at the beginning of the shift, and for all intensive purposes that ends the medical portion of their care for the rest of the shift. So in this case, a CNA was just doing a routine check on her patients when she noticed that this particular patient was not only not moving, he was not breathing either. She immediately called a code blue. Remember that I said that these nurses practice psychiatric medicine for a reason? Well, you just have to watch one code being run by them to know why this is true. The patient was found sitting up in bed. So in order to do CPR the patient has to be lying flat on the bed. When they pushed the patient down flat on the bed, the legs went up. When they pushed the legs back down, the head went up. After doing this a few more times, they realized that rigor had already set in, and any further efforts at resuscitation were futile. Thankfully, the charade was soon ended when the ER doctor arrived on the scene. I am sure there are great medically trained psychiatric nurses out there and that includes my first wife, I just have not many any yet.

Poop Rolls Down Hill, No Really.

My hospital had three patient rooms, semi-private rooms and private rooms. It just so happened that I had two little old ladies in the same room with the same problem. Constipation for one week. A patient not pooping for a period of week is starting to indicate a critical problem and requires drastic actions to rectify. Especially when they have been taking stool softeners all along. One of the less dangerous codes you can have is the good old code “brown”. Well, I have always been fortunate at getting patients that like to defecate frequently. Before I became a nurse, I never knew people could store as much poop as they do. These two little old ladies could not have weighed more than a hundred pound each had to have pooped half their body weight that night. My CNA and I were in virtual tears. They went back and forth between the two, going in tandem as it were. When the flood gates released they pooped from head to toe. We ran out of clean linen twice that night just because of those two little old ladies.

The Spider and I

Another simple body function that we take for granted is urinating. Though any elderly man with an over-active prostate gland will tell you that it is no fun. However, many things besides enlarged prostates can cause a reduction in urine output or stop it entirely. Let me be clear, here I am not talking about reduced production of urine due to renal problems, I am talking about people that are still producing normal amounts of urine but simply can’t eliminate it. This can become a critical problem quickly. Bladder infections can cause a blockage due to increased sediment caused by dead bacteria, usually a foley catheter or straight catheter will take care of this problem. But if the patient’s bladder is actively bleeding and creating blood clots , this requires a different intervention known as continuous bladder irrigation or (CBI). This can be a real pain in the ass. It can be quite painful for the patient and is certainly a lot of work for the nursing staff since we still have the rest of our patients to take care of. The earliest stages are the worst because the irrigation is by necessity done by hand and can be quite messy. You need to wear a gown and a face shield because there is that much of an issue with flying body fluids. Once you get rid of all the clots, you can just hang large bags of sterile fluid which keeps the bladder irrigated until it can heal by itself or a urologist can repair the occasionally recalcitrant bladder. By the way, urology is just not a popular specialty, so you may have to do this for quite a while. As it turns out, insurance companies just don’t think that urinating is very important because they don’t compensate the doctors very well (this is from the urologists themselves). Needless to say, this job is not one of a nurse’s favorite things to do. It is as I already mentioned very time consuming. But this is my patient so you have to know that there is a twist coming. Well, my patient was a biker dude, so his bladder problem most likely had another origin. Remember how I said that nobody liked to do bladder irrigations, well, this was not the case with my patient. Drum roll, please! Come on, you can do better than that! He had a tattoo of a spider web and a spider on the head of his penis. I kid you not, I could have sold tickets. I had nurses lined up down the hallway to help with the bladder irrigation. I actually had to set up time limits so that everybody had a whack at his penis, no pun intended. Only me. Needless to say that this was not my last penis-involved care that I came across in my career.

Can I have a leg up?

The hospital I worked at had an individual who worked at placing patients throughout the hospital. He was quite a funny guy because he placed two male amputees in one semi-private room. One patient was missing the right leg and the other missing the left leg. Well, the damned funniest thing was that they both took the same shoe size. They also had similar backgrounds and became fast friends. They even as it turns out went shopping for shoes together after they were discharged. So they only had to buy one pair of shoes. So it turns out that our prankster who liked to mess with the nursing staff, actually did a good thing.

Boy, do I have a story to tell you

One of our jobs as nurses is to collect admission information on new admits. Well, in nursing school we had been introduced with the term “confabulation” which is the creation of false memories in the absence of deception. They actually don’t even know that they are doing it. I should have picked up on the subtle hints given by my fellow nurses when I was taking this patient’s history. Just when I was finished taking all of his data and the patient had went into his room, everybody started laughing. Apparently, he was a frequent flyer and had burned several nurses before me. So that entire history of his was wrong. I had been so proud of myself that I had done such a great job. It is kind of funny now but it was a bit of a pain back then.

Anybody want a shower?

One thing that male nurses have to watch out is taking care of female patients. It is always a good idea to have a female co-worker in the room when you are providing their personal care, especially if you suspect that she has some issues. This was true of this rather obese lady who wanted me to bathe her in the shower. I told her that my CNA would be happy to assist her. As a way of getting revenge, she then went and told the charge nurse that I was having sex with the female patient in the bed next to her. Well, it certainly was news to her roommate. Of course, it never went anywhere but you can never be too careful.

Can I have a float?

This was my first float experience. I had just finished receiving report on my eight patients and the day nurses had all left when I was told that I was going to have to go to the IMC. So I had to report back to new nurses for patients I had not even seen. I then had to put in a short patient note for all eight patients. I then went to the IMC where I took care of five patients. I had just finished up giving my meds and doing my charting when I was told that I was going to have to float to the orthopedic floor where I was going to take care of 13 different patients. So now I had to give report to even more nurses so that I could move to another floor. When I finally got to the ortho floor, most of the nurses caring for my new patients had already left. What I walked into were written reports on the vast number of patients because the day nurses were not allowed to get overtime. So now I had to assess all 13 patients and give their morning meds to them. Thank god, that the meds were few but I did have to give all the pain meds for the patients who had just had surgery in the previous day. What a night! When I went back to my floor in the morning and told Tammy, my charge nurse what had happened she didn’t say a word. She showed no remorse whatsoever. No nurse should have been put in that position. Let alone a new nurse with less than one month of experience. Needless to say, the nurse manager in charge of my unit was not very happy.

The case of a beautiful spirit.

I have taken care of a lot of amazing patients throughout my nursing career but the most amazing patient I have ever taken care of was a middle-aged lady who had bone cancer. You may ask why she was so special. She had bone cancer of the skull and facial bones. Despite her terminal diagnosis she never let her spirit flag. She was always pleasant no matter how much discomfort she must have been experiencing. The cancer had eaten through the left side of her face and skull. You could actually see part of her brain and her mouth as what remained of her jaw opened and closed. She never had a cross word and was only too ready to share her experiences with the nursing staff. She especially enjoyed talking to the new nursing staff, it was as if she was trying to teach us about cancer. But in reality she was teaching us on how to be human. It has been years since I have given her any thought. I am sure she has long since gone to a better place. She came to mind when I was going through a list of patients in my head that I wanted to discuss in my memoirs.

Watermelon Ice Cream, anybody?

The next patient I want to mention delves into the inhumanity that people can exhibit towards the less fortunate. This patient was a simple and harmless individual who had hit upon tough times and had been subsequently turned out to the streets. While Las Vegas can be a great place to live, it can be hell on the homeless population. We have a very high crime rate against the less fortunate. This particular individual had the side of his head caved in by a baseball bat wielded by some bored juvenile delinquent. I frankly don’t know how he survived the assault because he had a dent in the side of his head the size of a softball. He finally recovered after multiple surgeries. One good thing that came of this event was that he was finally reunited with his family on the east coast. On his last day at our hospital, I asked him what he was going to do when he got back home. He said that he was going to sit under a tree and eat some watermelon ice cream. He never once spoke out against the individual that attacked him and he never displayed any anger or self pity for his condition. Another truly amazing person.

What not to do.

One case that I came across should never have happened. It involved a person who received a very caustic IV medication in a peripheral IV site. This medicine which is called Levophed should only be administered in a central line placed in a large blood vessel. This unfortunate person was shipped to our hospital so that we could clean up the mess. He needed multiple shots of Phentolamine mesylate, an antidote to Levophed to stop further damage from occurring. What happened was that IV went bad and the medicine extravasated into the surrounding tissue. By the time we got him, his skin was already turning black. He would require multiple surgeries to get a semblance of normality back in his hand. I am sure he must have been in a great deal of pain. But this person never complained about what had happened to him. I know I would have been extremely vocal.

Do you want a leg or a wing?

Every once and a while you get a little confused patient who likes to run around their room naked. This is not too much of a problem if they stay in their room. However, it does become a problem when they haul ass down the halls of the hospital. This is especially an issue when you have young family members visiting their relatives, so you have to act quickly. Maybe the way we responded to this little guy was ill-advised. Not only was he naked and fast, he was a little combative. The four of us grabbed an extremity and the next thing you know the patient was airborne about four feet above and perfectly perpendicular to the ground. All was well, the patient was immobilized and was ready for transport back to his bed where he was buying a new waste belt. When out-of-nowhere the little guy let out a hellish fart and his bowels just opened up. I have never seen such a small person poop so much. The poop splashed everywhere, it was like a dam had just burst. Since the damage had been done already, we just held him in place until he finished. There was simply no point on bringing him back to his room while he was still going to town. Why is it that so many of my stories involve bowel movements and other bodily functions, hell, if I know. I guess, don’t say it, don’t say it… “shit happens.”

Oedipus Complex?

While I am not sure if incest was actually taking place between the mother and her teenage son, it certainly appeared to be the case. Every time we went into his room she was cuddled up with him in his bed. It all seemed a little too creepy to me. I, unfortunately, don’t think that he is still alive. He just took too many risks with his diabetes. He would intentionally drive up his sugar levels to get admitted to the hospital so he could get his pain meds. His was a truly sad case and you just don’t know where everything started going wrong in his life.

What people will do in the name of beauty.

My next patient was another confused individual who I think was trying to become a woman, of that I am not entirely sure. His first mistake was to go to another country to get silicon implants in his butt. His second mistake was to give himself injections in his butt cheeks. I don’t know what he was thinking. You can almost guess what happened next, of course, he punctured the implant and got silicone poisoning in his back side. The wound he developed was just amazing. I don’t think it ever healed. He just kept on leaving AMA. I think it had to do with us not feeding his drug habit to his satisfaction. A few years later, I found out what had happened to him. He had just performed fellatio on one of his clients, when his client found out that he was a man, and in a fit of rage, he crushed his head with a tire iron. This was another sad case involving a very troubled spirit.

In the name of money.

Of all the cases I have seen, this one is probably the most heart wrenching of all. It involved a young adult who was born with Spina Bifada. He weighed maybe 60 pounds and his mental development was at the most of a 6-month old infant. He was totally contracted into a fetal position and what was worse, he was covered with decubitus ulcers. His family had insisted on taking care of him so that they could receive his disability checks. Obviously, he was not being taken care of. He was so light that there was no reason that he could not be frequently turned to prevent the wounds from developing or range of motion exercises being done on him to prevent contractures. I hope when their time comes there will be a special place reserved for them.

Boy, are you ugly!

This was another sad case where this poor lady was the victim of a dump and run by her family when they came to vacation in Las Vegas. Yes, that does happen. It takes place when a well- meaning family takes a loved one that is disabled with them on the trip only to find out that they are a killjoy and drop them off at the hospital so they can have fun gambling and watching shows. This particular patient was a pleasant elderly lady who was somewhat obese. What she suffered from was an uncaring family, partially due to their having a poor understanding of what it takes to care for an elderly and total care patient. She had a decubitus ulcer the size of a cantaloupe on her back side. In the language of wound care, it was a stage four decubitus ulcer in the sacral region. She had quite a sense of humor which made it even more sad. After I had dressed her wound and cleaned her up, she asked to see my name badge. This is what she said after closely examining it. “Boy, are you ugly!” I just thought that was the funniest thing. I have a feeling that she never recovered from this wound , it was simply too large and she was too high of a risk for septic infection.

Whoopee… that was fun!

While this was not the largest patient that I saw as a nurse, she was the largest patient that I personally cared for. She weighed in around 800 pounds. But after spending any time with her, you no longer noticed her size. She had the most infectious personality imaginable. She was from Alaska and was being taken care of by her boyfriend and his mother. Hers was another truly sad case. She showed me her driving license… she had been a truly lovely lady who had a, for real, glandular problem. Many people say that they gain weight because of glandular problems, this one actually did have one. I am not sure if they ever figured out how to correct it. I am sure that if she did not lose weight that she would have soon passed away. The life expectancy of someone so morbidly obese is typically not very long. Due to her large size she was on a special airflow mattress insert that was powered by two large fans. Three people could turn this patient. You needed two people to hit the fan buttons simultaneously and just one person to move the patient around. It was actually quite fun to do. When the fans were activated the patient was lifted up off the bed by almost a foot. That is why she said “Whoopee”!…She truly was enjoying the ride. Besides what else did she really have to look forward to being in that state.

You did what to what?!

You may remember that I said we took prisoners as patients. Well, I am sure that you would not be surprised on the things that they do to themselves while in prison. Apparently at some point in time, I am not sure if it is still a thing because I have only seen one case of it. But this patient did something very strange to his penis. Apparently, in order for a male prisoner to provide more pleasure for his lover during their love making, he had inserted a small sliver of a domino under the skin of his penis. It provided a bit of a hump that supposedly stimulated the prostate gland during anal intercourse. What they do is to take a domino and carve it to just the right thickness and size and then they make a small incision in the skin of their penis and push it in place. Then after it heals back over they are ready to go. Unfortunately, this is far from a sterile procedure and incision site routinely becomes infected. This means a hospital visit is usually in order. This also means that a urologist has to remove the domino which is followed by several days of antibiotic treatments. This ranks right up with “gerbilling” in the really weird shit department. Really, if you haven’t heard of gerbilling you really need to check it out on the internet.

It’s Raining Poop not Men

When I first started working there, we used washcloths and wash basins with soap and water to bathe our patients since time immemorial. However, that changed as disposable wipes came into the picture. Apparently they were more effective in reducing topical and wound infections because it was believed that the wash basins harbored bacteria. I don’t know if this was true because we still have the wash basins even now and we still have washcloths. What soon became a problem was that the patients and even some staff insisted on flushing these wipes down the toilet. As you can imagine, this caused untold problems with our plumbing. When the pipes got backed up, we were not able to flush any toilets or run any faucets. They could be down for hours as the plumbers cleaned out the lines. One rather humorous incident occurred when a senile little old lady flushed the toilet while all the lines were opened, and the plumbers got to experience brown rain. I thought it was funny, apparently my sense of humor was not shared by everyone, especially the sodden plumbers. I guess, they don’t like wearing raincoats and using umbrellas as they work. Every time I think about this incident, the song “It’s Raining Men” keeps on popping into my head, and I don’t know why.

How I showed a 95 year old woman a good time

I hesitated about including this story because frankly it is a little embarrassing. In my defense, I was a fairly new nurse when it took place. Also in my defense is that female anatomy changes as you age. When you reach 95 years of age your goods have now taken on a Picasso like visage. In this particular case, I was given the task of inserting a foley catheter into a 95 year old women. I actually went through two catheter kits before I was finally successful. After I had been at my task for a while, I noticed that my patient who was very confused was smacking her lips some. I did not give this much thought, so engrossed was I in trying to insert this catheter. The next thing I noticed was that she tensed up and her toes curled in. This is when I realized what I had just done. In my attempt at inserting the tip of the catheter into her urethra I had been hitting and stimulating her fun spot. I had just given a 95 year woman an orgasm with a foley catheter. I was mortified. When I told my fellow and senior nurse, who just so happened to be the famous Mary, she died laughing. She said that we would just keep this our little secret. Final outcome after we shared cocktails I eventually did get the catheter inserted.

Don’t Sit in that Chair!

We had a rather sweet and somewhat simple and yes obese CNA who for a time worked on our floor. Bless her soul! She really did try to do a good job but her size really did get in the way of her performing her job. I am not sure what the reason was but eventually she and the hospital parted ways. She had a bit of a stress incontinence problem and would pee on occasion while sitting in her chair while she entered her vital signs and did the basic charting required of a CNA. Everyone knew that she had a designated chair that she sat in, however, sometimes she forgot that and we would have more than one wet chair. This would not have been a problem but our chairs at the nursing station were cloth chairs. I don’t know what dumbass came up with that idea but we still have them in the hospital even now. So you soon can tell which chairs she sat in by the bath towel that covered them. The problem arose when a nurse from another floor came to help us out and nobody warned her of the situation. Now you had a nurse and a CNA walking around with a wet ass. How embarrassing! She had another bit of a problem, her hygiene left a little bit to be desired. Well, if you want to admit it she had a few more problems. She would eat the rest of the food on the patients’ trays and she would even eat some of our lunches in the break room. So maybe that is why she left our hospital. I guess, I will never know.

Push-ups with Sam Kinison

I am not trying to pick on CNAs but they sometimes are the most interesting of individuals. This young lady was a bit of a fire plug and was rather stocky in build. But one thing , she was the strongest woman I ever met. When she tugged on a patient, they moved. However, the real reason she was so strong and stocky and also why she had a bit of a stubble on her chin, was that she had low estrogen levels. She did not realize it until her and her husband tried to have a child. I felt bad about it but maybe it was for the better. She certainly was a strange bird. Of all the time that I worked with her, I did not put two and two together until she came in on one cold and blustery evening wearing a cap and a scarf wrapped around her rather thick neck. It is a good thing that I wasn’t drinking anything or that I did not have false teeth because they both would have gone flying. I had to go into another room , so I could laugh my ass off. I will just call her “Sammy”. Now you know who I was working with. She even sounded a little like him. I am not sure how we got on the subject but we did. We started talking about push-ups and exercise, in general. Sammy chimed in and said that she used to be good at doing push-ups. Well, I double dog dared her that she could not do 5 push-ups. So she dropped down on the floor in the nursing station and proceeded to prove me wrong. After almost stroking out after her third push-up, I stopped her before we had a code in the station. I have seen beets that were lighter in color to the shades that she turned trying to do those push-ups. So that is how I got to see Sam Kinison do push-ups, well, not really.

Can you please pass the soap?

A rather large female patient of mine told me that she was going to take a shower, I said, “Thank you for letting me know.” Something gave me a funny feeling about this, she had been hitting on me for some time. So I went out to the nurse’s station and told my LPN friend Bobbie that my patient’s shower light would be going on in just a few minutes. I asked her if she could respond to the light. She looked at me kind of strangely and said OK. Like clockwork, just after I had asked her the light went on. When she went into the bathroom, the patient was standing in the shower with the curtain open up and she was totally naked and all lathered up with shampoo and soap. Bobbie asked her how she could help her, and she said it was a mistake, she had not meant to pull the cord that was two feet away from the shower. Boy, did I dodge that one, or so I thought I did, until the next story. When Bobbie came back out of the patient’s room, she just shook her head and said only me.

I am going to Maine

I am not sure why I used to attract large female patients but I did when I was younger. When this patient was finally ready to be discharged, her husband asked me to come into his wife’s room. This is where he thanked me profusely for saving her life. I am not sure what I did to deserve this claim, but I said, “Thank you.” It was then that they invited me up to Maine to spend time at their camp, anytime I wanted to. I quickly read between the lines and said, “Thank you. I appreciated the offer.” I think they wanted me to be the jam to their sandwich. Maybe I was reading too much into it, but I think not. You did not see how she fawned all over me when I cared for her. She was always showing her all too ample body to me, and besides she was the women who wanted me to take a shower with her in the previous story.

Sex in the City

I know I mentioned that homeless patients were pretty common at this hospital. What I may have neglected to mention is how delightful they can be. Sarcasm is dripping here. This male patient had a constant female guest accompanying him. We soon found out why she was so close to him. Well, my little Hispanic CNA found out not once but twice why she was with him. This CNA never could seem to grasp the concept of knocking on a patient’s door before entering. I think after this night she finally grasped the concept. I think what is so alluring about being in a hospital to the homeless person is that they get to sleep in clean beds and eat warm food. Food that was not found in a dumpster, that is. However, this couple took it to a whole other level. We did find out one thing, our homeless patient was not as sick as we originally thought and his partner was extremely athletic. Come on, guys do I need to paint you a picture?! Both times my hispanic CNA entered the room unannounced, all I heard was an “eep” and the sound of a quickly closed door. You would have thought that she would have learned her lesson the first time, or maybe she thought that she gave a long enough time for them to finish. But damned, if it did not happen a second time with the same result. So either they were still going at it or they had started another round, I don’t know which. But I do know one thing, hats off to them. I think the second time was a game changer for my CNA. After that she continued to knock on doors at least till the end of the shift. When much to my chagrin she quit, saying that she could not work under these conditions. I was sorry to see her go, she really was a hard worker.

The Infested Patient and the Housekeepers

In previous chapters, I mentioned that I could not stand people getting abused, especially ones that could not speak up for themselves. Well, here is a story to prove this. The patient in this story actually spanned two hospital visits. The second one ended in the ER and did not make it to the floor. But the grapevine provided me with full details of those events. Since it involved the same patient and I think it is germane to the story so I will include it here. I am not sure why this patient was admitted to the hospital but I am sure it was an unnecessary admission. This patient was a truly filthy patient. I actually think if he whistled to his clothes they could have come to him. If you have not smelled a longtime homeless person just think of the following…dried sweat that had cycled several times followed by stale cat urine, feces and vomit. Now you have an idea what the truly disgusting homeless person can smell like. I am also not saying that they are all like this but this one truly fit the bill, right down to being infested with body lice and probably bed bugs as well. When my CNAs went through his clothing, a whole black cloud exploded from his clothes as they shook them out looking for illicit drug paraphernalia. They immediately stopped what they were doing and promptly left the room. They both hastily called for hospital scrubs and took showers and vowed not to go back in the room. Thankfully, the patient was discharged the next morning. You know what the kicker was, my daily counterpart gave the patient a bus token. Can you imagine that, I am sure the bus became infested too.

Now, this takes us to the housekeeping staff. The fumigators refused to go into the room until it had been cleaned up. Can you believe that shit? Isn’t that their job to wear hazmat suits and kill vermin with noxious chemicals? These two housekeepers were great ladies, they came to all my parties at my house, so needless to say, I was pretty close to them. Their boss, also a friend of mine and someone who should have known better sent them into the room to clean it up. Well, they got infested themselves, the bugs actually got into their underwear. They had to also to take showers and change into hospital scrubs. They also had to throw all their clothes away. When they told me this they were in tears. Well, needless to say I blew a gasket. I called the housekeeping supervisor and I let him have it, friend or no friend. I made him give the two housekeepers a clothing allowance to replace their outfits. How demoralizing was that, they both had the right to quit without notice. But they staid the course. One good thing that came out of it, the supervisor treated his staff a little better.

Visit number two. This time he never made it out of the ER. Of course, he infested it as well. The reason that he was not admitted this time, was that they caught him having sex in the room with his male lover. Ok, talk about being really gross, can you imagine that?! I never heard about him being readmitted, so I guess they finally learned their lesson. It turns out that all he wanted was three “hots and a cot”.

Randy, The Friendly Ghost

I once worked with a male LPN named James. He was a big muscular man that made me look small. To give you an idea I stood 6″2′ and weighed 230 lbs back then. So when I say he was a big man, he really was a big man. I, however, had no idea how strong he actually was until he helped me with a patient. He was very hardworking and very friendly and we soon became fast friends, that is until he up and disappeared with no notice. But his vanishing act is not why I bring him up. We had this overly large gentleman who weighed in at a svelte 500lbs. I do not know what possessed my two CNAs but they thought that after covering him in a white moisturizing lotion that it would be a good idea to get him out of bed and escort him to the bathroom. Well, as soon as they got him out of bed they became aware of the error of their ways. Because he immediately became unsteady on his feet. He could neither walk to the bathroom nor could he get back into bed. So they yelled for help out in the hallway. Well, James and I raced to the room. I chose to get behind the patient and placed my arms under his armpits. I guess I thought we could pivot him onto the bed. James grabbed him by the front mirroring my armpit hold. The next thing I knew, I and the patient are both in bed. He lifted up over 730 lbs of humanity like it was not even there. Unfortunately, I was in a bit of a pickle because now I found myself underneath a 500lb human being. All you could see were the tips of my hands and feet and the top of my head. I could not breathe or move. All I could do was gasp out the word, “Help!” Well, my staff soon realized my demise and they helped me out of my predicament. When I came out from underneath my large patient, I was covered from head to toe with that damn white lotion that they had lathered all over him. I looked like Casper, the Friendly Ghost…I kid you not. The patient was so embarrassed and apologetic especially when he saw me limp out of the room in such a state. All I was thinking as I left the room was that I was glad that James liked me.

Menage a trois

There is an old saying that “Three’s Company”, wasn’t that a TV sitcom?  This was certainly a unique situation. The patient was the male partner of this threesome. He always had at least the wife or the girlfriend with him sometimes both. I asked him how he did it. He said “I don’t know but they are the best of friends” and he is living the life of Riley. Apparently there is no jealousy at all. One night, the girlfriend came out asking for towels and wash clothes, I guess it was her night to shower with the patient. The next night it was the wife’s turn and the last night he was there, it was time for all three of them to be in the shower. Sometimes I think I could write stories for “Red Light Diaries.” I don’t remember what he was in the hospital for but who in the hell, cares. Oh, one more thing, both women were gorgeous, so eat your heart out.

I dropped the Dilaudid, Honest

I mention this story because it involves Linda and it covers both of her weaknesses… gullibility and her overly trusting nature. We had a nurse float from a different floor one night. She seemed to be all right at first but then I began to have my suspicions. She would run around like a mad woman and had a ravenous appetite eating patients trays that were left over and eating extra food in the refrigerator for patient snacks. Then she would start slowing down and eventually she would disappear only to come back 20 minutes later and start the cycle all over. I really became suspicious when Linda comes up to me and tells me about what has been happening. She had been witnessing the waste of Dilaudid without actually seeing the wasting part. First of all, she was an LPN, so I am not sure if she should have been wasting the medicine at all? But that is neither here nor there. What finally clenched it was when she asked me at the end of shift to waste morphine for a patient that was being discharged. I looked the patient up and he had never asked for pain meds the whole time he was at the hospital. So I refused. I contacted the pharmacy and notified the house supervisor and then my nurse manager. I am not usually the whistle blower, I know everybody can make a mistake from time to time, as long as it is not malicious or affects the patient. But this was too obvious. I hope Linda learned a lesson from this experience.

My Patient Has No Blood Pressure

I include this story because even the most experienced nurse can experience tunnel vision. This involved a male nurse. In a medical/telemetry floor there is only so much we can do to increase a patient’s blood pressure. One is to give them extra intravenous fluid. We can also give them albumin which is a volume expander and draws fluids out of the surrounding tissue and returns it to the blood vessels. Thirdly, we can change their position. By lowering the head of the bed and raising the feet we increase the volume of blood in the core of the body, thereby improving the blood pressure. If the blood pressure does not improve and it reaches a critical level, that patient has to be transferred to the ICU where they can receive more advanced blood pressure support. So after the third time of my nurse coming out to ask for guidance, I said “I will go in to see the patient and see what else we can come up with before we woke up the doctor”. His blood pressure was not critical…just worrisome. That is why we had not already called him. By the way, the position change we initiated is called the Trendelenburg Position. What is the first thing I saw when I walked into the patient’s room? Well, I will give you a hint…I was looking for the blood pressure cuff. After I saw where it was located, I gave the nurse a wave of my hand to have him come outside in the hallway. The patient was alert and I did not want to embarrass him in front of the patient. I asked him to stop and think of one thing. I asked him where he had placed the cuff? He immediately knew what he had done. He had placed the cuff on the patient’s ankle. So the higher he elevated his legs the lower the blood pressure got. There was nothing wrong with the patient. The fluid bolus was enough by itself to fix the problem. He was just a little dehydrated.

It’s A Boy!

Do you believe in the supernatural? We had the patient who used to work at our hospital. She had been very sick the whole time she worked on our floor. She never asked for any sympathy, as a matter of fact, I never even knew that she was a terminal case. She just loved caring for patients. She worked right up to the last month of her life. After that she was unable to continue because she had just become too weak. The only thing that was keeping her going was that she was waiting for the birth of her grandchild who as it turned out was a boy. The family had made her a DNR because they didn’t want her to suffer. So halfway through the night, the family called to tell me that her daughter had just given birth to a healthy baby boy. They asked me to go into the room to tell her that her grandbaby had arrived and was healthy. I went into the room, mind you nobody had entered her room after the call had been made. I was the first one to do so. When I went in to the room I saw her lying there with a smile on her face. She was no longer breathing. She had just passed away. Her waiting was finally over. Now you tell me doesn’t that give you goose bumps? I know it does to me.

My COVID-19 Patient

I started caring for him when he first was transferred to the ICU. He had progressed to the point where he needed the Hi-Flo nasal cannula and occasionally, the non-rebreather mask as well. You may recall this from my generic patient monologue in my previous book. There are several reasons why he became so special to me. He was just a few years younger than me for one, so we had a lot in common, he was a public servant as well. He was much loved by his co-workers and they provided a 24-7 vigil outside the hospital the entire time he was a patient there. Even though it is ill-advised we became fast friends. I know this never should happen, especially in the era of COVID but it did. I am only human after all and not a heartless robot. That is why I became a nurse to help the less fortunate. The thing that set him off from all the patients I cared for was the number of days I actually cared for him. I cared for him for a total of 12 days which spread out over five weeks, I was even off work for a seven-day stretch and when I came back he was given back to me. This trend continued every week, I would be off my three to four days and like clockwork when I came back, he was my patient again… that is until he was no more.

It was during my period of seven days off that he was intubated and now I was no longer able to converse with him. It was amazing how far he had slid down the COVID rabbit hole in those seven days. It truly was heartbreaking when I came to the realization that he was going eventually become just another pandemic statistic. Maybe this is what I am doing with this addendum of sorts, I am trying to give this amazing individual a little bit of immortality. He gave so much to his community. He worked three jobs all involving public service in one form or another. He was also the father of eight children and husband of a loving and faithful wife, an individual who I got to know even better than her husband. Every night that I cared for him, I conversed with her on the phone not just talking about his condition but discussing their lives together and all their wonderful children. While at first it was a chore but after a while I actually looked forward to talking to her. Because I knew that I was the only one who had developed this relationship with not only her but her husband as well. Somehow from the very beginning I felt in my heart his was going to be a very special case for me, one that I would not soon forget.

As each night progressed, he became weaker and sicker, he too eventually required a chest tube to keep his lungs inflated. Unfortunately, his chest tube gave us plenty of trouble, a couple of times I thought we had lost him when his chest tube clotted off. However, once the obstruction was cleared he would bounce back a little. Every night that I talked to his wife, I would tell her of his little victories, not to give her false hope but to let her know that he was still fighting. I always tried to be not only honest but positive as well. Over the years, I have seen many miracles. I have seen patients survive when I thought all had been lost, and it was only by the love provided by their family that they persevered and survived. They just never gave up on their loved ones. One day, one of these patients came back to visit our floor to show her appreciation. It was moments like this that made all the struggle and heartache worthwhile. That is why I have such a hard time giving up on my patients because I have seen these miracles. So I try to impart this to the families, that no matter how bad things get, you have to believe in them. Because after all who else does the patient have to love and care for them?

My patient finally breathed his last breath mainly due to an unforeseen complication. Thankfully, his wife had previously out of love and selflessness made him a DNR, so his final moments were not torture. He simply passed away, his body no longer able to keep up the fight. It is out of necessity that I keep his identity private. I have no easy way to reach his wife and I think it would be in poor taste if I did so because I would only re-open the all too recent wounds his loss has created. So I will pay homage to him in my own humble way. I hope with time, the family will heal and be able to move on. They still have three children left at home, so I am sure that it will be a difficult process but I know that she will not be alone in her struggle. In his life, he made a lot of friends, people that will be there for her. I wish her the best.

I write this final section for a somewhat selfish reason, I am hoping that it will be a bit of a catharsis for me. I just finished doing a self evaluation for PTSD and I have over three quarter of the symptoms listed, so I guess, I have some healing to do as well. You never know what life will bring you, I guess all we can do is to keep on fighting.