A nurse’s worth

Yesterday at work, I was tested. I was pushed and I was so saddened.

It was a mixed bag of sorts. I took care of a lady who was discussing hospice care yet was still in relatively good spirits. In fact, after she woke up from a deep sleep, she looked around at her family’s waiting faces and said, “Shit. I’m still alive.”

I had another patient who was bedridden and required immense amounts of care around the clock.

A few of the other patients were relatively self-sufficient and kept to themselves.

Then there was *Jane. (Obviously I changed the name.) Jane was in her late nineties and, from what I gathered, had a touch of OCD. Everything had to be just so and of course, with her generation, she knows what it means to work. Therefore, she never could sit still.

But, for a lady in her late nineties, she was surprisingly very good on her feet and of course didn’t want to be a bother. This translates to, “Don’t worry about me, dear. Go about your day. I’m fine.”

And, for the first 8 hours of my shift, that was just fine, because she wasn’t too much trouble.

But, see, a funny thing happens to some dementia patients when the sun starts to set. And it’s funny, as in, OH MY GOSH NOT FUNNY AT ALL, because, well, yah.

In a nutshell, Jane got pissed.

It started out all innocent, she wanted to go to her room downstairs on the first floor. But we kept her occupied with ice cream. A lot of ice cream. Apparently, Jane eats a half a gallon of ice cream every night.

Then she started to get fidgety. Because, honestly, what person wouldn’t after the amount of ice cream she had just inhaled? This started turning into paranoia and she immediately stopped trusting us.

Fast forward to two hours later, several failed attempts at calming and redirecting and we’ve got ourselves a situation. Jane wasn’t going to sit down. Jane wasn’t going to listen to reason. Jane wasn’t going to do anything, because we were all against her and were very bad people. And Jane wanted to hit and kick and punch and bite. But Jane was having difficulty breathing and she was getting weaker by the minute.

So I called her doctor to come up and see her immediately.

When the doctor showed up, she tried to get her to go into her room to talk. She tried every psych-trained bit of reasoning in the book, and failed.

And then, Jane did what most confused and scared patients do – she grabbed the doctor’s stethoscope and started swinging.

Here’s a lesson for those who aren’t in the medical field. You never, ever leave something on your person that can be used against you. Medical scissors should be removed from your pockets, chains and stethoscopes removed from your neck, and hoop earrings are a huge no-no.

The doctor took a few hits as did I, on my hands and my arm. Both of which are bruising up.

Long story short, we called for backup and had many, many people – most of which men, come up for assistance.

Now. Here’s where it gets dicey. Here we have a confused, scared ninety-something year old person who could very well fall and break something, have a heart attack or go into respiratory failure. My primary goal, as with any patient, is always their safety and well being. So, while it may seem barbaric to others, the fact that it took several people to get her into her bed and out of harm’s way was a priority and a major necessity. She wasn’t safe.

When I signed up to be a nurse, no where in it did I ever think I’d have to physically restrain another human being. Never did I think that I’d have to quickly draw up medicine and inject it into their backside. Never did I think I’d have to look at someone in the eye as they tearfully cried, “Why are you doing this to me?”

Never.

But sometimes to get to C, we can’t just go to A and B. Sometimes we have to go to Z before we get there. Sometimes we have to realize that it’s about what’s best even if it doesn’t seem what’s best. And sometimes we have to protect ourselves.

But I left work defeated. I’m not a mean person. I’m not a physical person. And what I was forced to do for the better of my patient nearly broke me.

I often wonder if I have what it takes. If this was a younger person, I’d have no issue restraining them. I’d have no problem putting them in restraints. And I’d certainly have no problem telling them what I think. But this is a woman who worked hard her whole life and is now left with a depleting mental capacity and was scared. She couldn’t understand why we wouldn’t just let her go downstairs to her room. No, she wasn’t in the hospital, she was at her house. Why don’t we believe her? Why are we being so mean?

And while I tell myself, we weren’t being mean, we were doing what it took to keep her safe, I still feel shitty.

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About Cassie

Two sisters from two misters. What could be more fun?

Posted on March 18, 2012, in Cassie. Bookmark the permalink. 8 Comments.

  1. Ouch.

    That’s all I got.

  2. Deb K from Harrisburg

    I think by giving her the shot to calm her down, you did treat her as humanely as possible. The least awful of the bad options was what you were left with. You do have what it takes because your empathy and compassion have left you reeling. I truly believe that had this situation not affected you, and you had simply left it behind when you left your shift, then that would be the time to think about another career. I hope that you feel better soon. One last note: my father-in-law has Alzheimer’s and sundowns and it’s not pleasant. It is so difficult to know what to do because there is so little that can be done.

    • Deb, over the years you’ve always known exactly what to say to make me feel better, and I want you to know that I honestly appreciate it. Thank you so much for this.

    • Debra M Kriete

      Cassie,

      I’m so glad you found some comfort. My heart was heavy when I read your blog this evening. You are such a wonderful person. Keep doing what you’re doing. Tomorrow your heart will be a little less heavy. I hope you got some extra hugs from your kiddos.

      Deb

      From: Cassie Conti [mailto:cassandrelu@gmail.com] Sent: Sunday, March 18, 2012 8:40 PM To: comment+ley-xnrzyx3mpq1qf-56g9082@comment.wordpress.com; dmkriete@comcast.net Subject: Re: [Sisters From Different Misters] Comment: “A nurse’s worth”

      Deb, over the years you’ve always known exactly what to say to make me feel better, and I want you to know that I honestly appreciate it. Thank you so much for this.

  3. I agree with what Deb said. You did the best you could with the situation. She was a danger to herself and to others. But I know that’s so tough to do that to someone who is so confused. Here’s to hoping that sunrise is better for the both of you. *hugs*

  4. As are many people, she was lucky to have you as her nurse.

  5. I sometimes forget that when you leave the house to work, it ain’t all blood-pressure-taking and making out in the broom closet like it is on “Gray’s Anatomy”. That is ROUGH.

    But most importantly, I’ve learned that the next time I’m in the hospital, I can ask for more ice cream than they give me. And if they don’t want me to have it, I can throw a FIT.

    • mrsbachelorgirl

      And then you can get a shot of Haldol to help you sleep! WINNING.

      Seriously, my grandmother, who was more like my mother than my actual mother, died of Alzheimer’s, and I can say unequivocally that Deb is right. Better a shot in the tuchus and a nice, long, deep sleep than her getting progressively more agitated, angry and frightened. Because that’s a one-way ticket to a psychotic break, and nobody wants that. It sucks so, so bad, but you guys did the right thing.

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