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 various reasons. We, as healthy individuals, often take our basic body functions for granted, that is, until they cease to function or, in some cases, work too well, such as with diarrhea. Who would think that diarrhea could be life-threatening, but it can be. If you are losing 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 that you can get in trouble quite quickly. If your magnesium and potassium levels become imbalanced, your muscular system’s ability to function properly is compromised. 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.

Stop the Damn Car!!

I decided to add this story even though it doesn’t involve patients. Frankly, I wasn’t even a nurse at the time. It took place on my first day of nursing school. I had just wrapped up my first day, and my head was splitting from all of the new crap that had been pounded into my swollen cranium. I had just pulled out of the campus and was headed down Ridge Rd on my way home in Holiday, FL. I came up to a red light where I was patiently waiting when I noticed two things, first of all, I was parked behind Judge Rasmaussen, who was fondly known as the “Hanging Judge.” His reputation was earned because of the hard line he took when presiding over DUI cases. A drunk driver had killed his daughter. He was driving a very large tan colored older model Ford Bronco. Of course, I was going “Oh, Shit,” what if something happens? This judge will surely cook my goose. Second of all, I noticed a rapidly approaching black sports car with the driver talking on his cellphone and oblivious of the peril that awaited him.

I just sat there for what seemed like a week as all these thoughts flashed before me. What the hell do I do? Do I pull off the road, I did have a few feet to spare? No, that wouldn’t work; I would only get hit in the side and probably get killed in the process. I thought of honking my horn, but that would have only pissed off Judge Rasmussen. So I did perhaps the dumbest thing I could do, and that was to stomp on the brake pedal, so I would not damage the judge’s Ford Bronco. I also tensed up, which was another dumb thing to do. But how in the hell do you remain calm when a car is approaching you at the speed of sound? That is right, he still had not seen me stop at the red light.

You know what was priceless? The look on his face when he finally saw me. What sweet revenge, that damn jackass. I could see the whole show unfold. He had a significant Oh Shit moment, where he most likely crapped his pants, and he then dropped his phone as if that was going to help. He jammed on the brakes, but the 20 feet separating us did not give the car much time to slow down. I estimate that he hit me going at least 40 miles an hour, which was verified by my insurance company when they evaluated the damage. The only thing that saved my van from being totaled was that I had a six-point hitch with a ball socket attached to the back of my van. It provided a great deal of rigidity to the frame. It also acted like a ramming object as it pierced the front of his sports car’s radiator. That was the second priceless moment I experienced when he got out of his car and saw the damage it had sustained. The damn jackass, it served him right.

I am sure I lost a few brain cells as my bell got seriously rung. I was almost knocked out. When the judge jumped out of his Bronco and ran over to see me. Of course, he did so in manner that comported well with his majestic standing. I think I was more terrified of him than I was of any possible harm that my have befallen me. Much to my surprise, he turned out to be the warmest and kindest person that I have ever met. He asked how I was doing and he even called the police and the paramedics. He took all the information from the guilty driver and waited till the authorities arrived. All I did was basically drool and see stars.

When the paramedics arrived at the scene, they put a rigid cervical collar on me they strapped me down to a rigid board, and then to a gurney. I was still too out of it to even walk. Little did I know the worst was still to come. The ambulance that came to pick me up was the size of a damn tractor-trailer. It had absolutely no suspension. The driver should have been competing in the demolition derby. He managed to hit every bump and pothole on the road to the hospital. If you have ever visited Florida, you will know about all the damn potholes. I think I had to get my van realigned every damn month, thanks to them. Not only did he hit every bump, the person attending to my every need in the back of the ambulance “NOT!!!” allowed me to slide up the rigid board until the straps were up to my neck and were cutting off my ability to oxygenate the few remaining brain cells that I had left. He finally released the straps after I had turned an interesting shade of blue.

After it seemed like we had been on the road for at least a thousand miles, we arrived at the hospital. You would think the worst was over, but again, you would be wrong. Now I had to pee like I had never had to pee before, all thanks to my driver, Mario Andretti Jr. I was offered a urinal, but they would not release me from the board and straps, so that was useless. They said I needed a CT scan before they would release me from my shackles. I had also started to develop a real humdinger of a headache, which resulted in me becoming very nauseated. They, of course, could not give me anything for the headache, but they did provide me with something for the nausea. Vomiting while flat on a board with a cervical collar would not be a good thing. Of course, being true masochists that they were, they gave me IV Compazine. In the 20 years I have been a nurse, I have never administered the medication. Well, I can tell you why. It was so damn strong that my nausea was immediately cleared up, but now I thought my skin was going to crawl right off of me. I became so agitated that I thought I was going to go crazy. What a nice one-two punch. I not only had to pee still, I had a massive headache, and now I was going crazy, and don’t forget, I still could not move.

Now they bring me to get my CT of the neck. Of course, they wanted to make sure that I was OK, so they ordered it with contrast. Well, I have never had a CT with contrast before. Nobody told me that it would feel like I was going to pee when it was injected into me. Well, don’t you burn your ass? Finally, I managed to get through the CT and was brought back to the hallway where I was unceremoniously left to suffer. Finally, after what seemed like an eternity, the ER doctor came and told me that my neck was not broken and my brain was as normal as it was going to get. When they finally released me from my restraints and straps, I virtually leaped to the bathroom. I want you to know that I had the most satisfying pee of my life. I think I had to flush twice because I almost overflowed the toilet bowl.

What a way to start my nursing career!!

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 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 was 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 at 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 significant 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 removed, they can then be treated for their psychiatric issues. You may ask why this is the case. Well, you don’t want these patients to have IVs 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, there is no way to tell when a patient dies. But the rule is that 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 intents and purposes, that ends the medical portion of their care for the rest of the change. So in this case, a CNA was doing a routine check on her patients when she noticed that this particular patient was not only not moving, but 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 have to watch one code being run by them to know why this is true. The patient was found sitting up in bed. So, 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 met many 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 elderly women in the same room with the same problem. Constipation for one week. A patient not pooping for a 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 in getting patients who 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 pounds each and 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. However, any elderly man with an overactive 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: I am not referring to reduced urine production due to renal problems. Instead, I am talking about individuals who produce normal amounts of urine but are unable to 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 (CBI). This can be a real pain in the ass. It can be pretty 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 pretty messy. You need to wear a gown and a face shield because there is a significant issue with the transmission of infectious diseases through bodily fluids. Once you get rid of all the clots, you can 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 not a popular specialty, so you may have to do this for quite a while. As it turns out, insurance companies don’t consider urinating very important, likely because they don’t compensate doctors well (this is according to 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 had to set up time limits so that everybody had a whack at his penis, no pun intended—only me. Needless to say, this was not my last penis-involved case that I came across in my career.

Can I have a leg up?

The hospital I worked at had a staff member responsible for placing patients throughout the hospital. He was quite a funny guy because he put two male amputees in one semi-private room. One patient was missing the right leg, and the other was 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 went shopping for shoes together after they were discharged, as it turns out. 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 to the term “confabulation,” which is the creation of false memories in the absence of deception. They 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 gone into his room, everybody started laughing. 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 for doing 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 for 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 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 a 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. Now I had to report to even more nurses before 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 them their morning meds. 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 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 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 were trying to teach us about cancer. But in reality, she was teaching us 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 as I reviewed 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 harmless and straightforward individual who had hit upon tough times and had been subsequently turned out onto 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 who 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 highly vocal.

Do you want a leg or a wing?

Every once in 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, but 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 ready for transport back to his bed, where he was purchasing 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 in 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 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. It was an unfortunate case, and it’s hard to pinpoint 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 which I am not entirely sure. His first mistake was to go to another country to get silicone 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 backside. 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 distraught 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 Bifida. He weighed approximately 60 pounds, and his mental development was comparable to that of a 6-month-old infant. He was 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. 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 who 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 backside. 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 at around 800 pounds. But after spending any time with her, you no longer notice 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 unfortunate case. She showed me her driving license… she had been a charming lady who had a, for real, glandular problem. Many people say that they gain weight because of glandular issues; this one did have one. I am not sure if they ever figured out how to correct it. I am sure that if she had not lost weight, 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 pretty fun to do. When the fans were activated, the patient was lifted off the bed by almost a foot. That is why she said “Whoopee”!…She truly was enjoying the ride. Besides, what else did she 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 you won’t be surprised by the things they do to themselves while in prison. Apparently, at some point, I am not sure if it is still a thing, as I have only seen one case of it. But this patient did something very strange to his penis. 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 offered a bit of a hump that supposedly stimulated the prostate gland during anal intercourse. What they do is 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 the incision site routinely becomes infected. This means a hospital visit is usually in order. This also means that a urologist has to remove the dome, which is followed by several days of antibiotic treatments. This ranks right up with “gerbilling” in the peculiar shit department. Really, if you haven’t heard of gerbilling, you 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. However, that changed as disposable wipes came into the picture. 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 and 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 open, and the plumbers got to experience brown rain. I thought it was funny, but apparently, my sense of humor wasn’t shared by everyone, especially the sodden plumbers. I guess they don’t like wearing raincoats and using umbrellas while working. Every time I think about this incident, the song “It’s Raining Men” keeps 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 relatively 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 woman. I went through two catheter kits before I was finally successful. After I had been at my task for a while, I noticed that my very confused patient was smacking her lips. 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-old 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 keep this our little secret. 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 tried to do a good job, but her size hindered her performance. 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 can soon 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 have a nurse and a CNA walking around with a wet ass. How embarrassing! She had another issue; 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 can be some of the most interesting individuals. This young lady was a bit of a fireplug and was rather stocky in build. But one thing, she was the strongest woman I’ve 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 stubble on her chin, was that she had low estrogen levels. She did not realize it until she 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 that I could laugh my ass off. I will 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 five 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 than 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, and she was 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 following 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 guess 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 woman 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 standard 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 initially 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 perhaps she believed she had given them ample time 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 was a hard worker.

The Infested Patient and the Housekeepers

In previous chapters, I mentioned that I could not stand people getting abused, especially those who could not speak up for themselves. Well, here is a story to prove this. The patient in this story 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, 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 truly filthy. I think if he had whistled to his clothes, they could have come to him. If you have not smelled a long-time homeless person, 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 a truly disgusting homeless person can smell like. I’m not saying 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, 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 got into their underwear. They also had 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 stayed the course. One positive outcome was that 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. Okay, let’s talk about being 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 who 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 was a big man. I, however, had no idea how strong he 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, 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. He immediately became unsteady on his feet. He could neither walk to the bathroom nor 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, the patient and I were both in bed. He lifted over 730 lbs of humanity as if it were nothing. 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 predicament and helped me out of it. 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 a TV sitcom.  This was certainly a unique situation. The patient was the male partner of this threesome. He always had at least his wife or his 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. 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 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 covers both of her weaknesses: her gullibility and 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 madwoman, having a ravenous appetite that led her to eat patients’ trays that were left over and to help herself to 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 became suspicious when Linda came up to me and told me about what had 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 clinched it was when she asked me at the end of the shift to waste morphine for a patient who was being discharged. I looked up the patient, 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 whistleblower, 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 provide them with albumin, which is a volume expander and draws fluids out of the surrounding tissue and returns them 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 blood pressure. If the blood pressure does not improve and it reaches a critical level, the patient has to be transferred to the ICU, where they can receive more advanced blood pressure support. After the third time, my nurse came 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 wake 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 was 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 a 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 say to 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 into 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 was first 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 I, for one, so we had a lot in common; he was a public servant as well. His co-workers loved him very much, and they provided a 247 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 have happened, 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. What set him apart from all the patients I cared for was the duration of my care for him. I cared for him for a total of 12 days, which spread out over five weeks. I was even off work for seven days, and when I came back, he was given back to me. This trend continued every week, I would be off for 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 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 realized that he was going to become just another pandemic statistic eventually. Perhaps this is what I am doing with this addendum: I am trying to give this exceptional 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 whom 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. At first, it was a chore, but after a while, I looked forward to talking to her. Because I knew that I was the only one who had developed this relationship with her and her husband. From the very beginning, I felt in my heart thatthis 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.

They Call Me James Bond

This was a strange case. The family opted to pay out of pocket for the patient to stay in the ICU for his entire stay in the hospital. They also wanted us to use an alias to protect his identity. They were concerned for his very safety. They believed that someone had tried to kill him. I frankly thought it was his ex-wife who tried to kill him. She wanted him “zonked out” on medications. He was quite the handful. I believe that he suffered anoxia when he was coded. Finally, he ran out of money, and he was sent home. I wonder if he ever met Miss Money Penny?

Security!

This next story involves me personally. In every hospital where I have worked in the city where I currently live, my vehicle has been vandalized or broken into. The first hospital I worked at had half my motor and one headlight stolen, despite being under surveillance by closed-circuit cameras and monitored by parking lot security personnel. In the second hospital I worked at, a thief broke in through the back of the truck cab, using the motorized sliding window, to steal a bag full of picnic supplies, worth about $2.00. At the third hospital I worked at, over 20 gallons of gas was stolen over a period of four nights, including breaking open a locked gas cap and cover that I installed. The hospital I am currently working at they stole over $900.00 worth of supplies and gear out of my van, including a collapsible ladder and a used female urinal. What the hell. To do this, they had to open up five different doors on the van while the parking lot was guarded by security personnel. The other two lots were also monitored by cameras and patrolled by 24-hour security guards. Are you seeing a pattern here? When I contacted the police, they showed little or no interest in my report or in investigating it. It turns out that the only reason I was filling out the reports was for insurance purposes.

I have hundreds more stories that I could tell. However, I have a license to maintain and patients to protect. Maybe after I retire and I no longer have a license, and the trail is cold, will I be able to finally tell some more of them?