Sunday, June 21, 2009

Letting Off Steam


When it comes to a hospitalized family member, I can be a nurse's nightmare. I'm that big mouthed family member who won't stop nagging until my loved one's needs are met. I start out pretty gently, but I don't make it a secret that I'm fairly bright and a damn good nurse. If a nurse does not step up to the plate, I let my displeasure be known. I'm fierce like that. I'm not rude, but I'm not a pushover. If you're ever sick, it's me you want in your corner. I was a pain in the ass like this with my patient's too-I'd always fight for their needs and rights. Rights? That's correct, patients have rights. At the core of these rights is the expectation that a patient will be treated with dignity.

What is dignified about making a fresh post operative patient wait an hour and twenty minutes for pain medication? Waiting until an 82 year old man is near tears with agony and begging for pain medication is unacceptable. Offering that same man one darvocet tablet after he's been begging for an hour and twenty minutes is just bullshit. It's going to take another hour for the patient to get any sort of relief from oral medication and frankly, what good is one darvocet going to do for someone in extreme pain? I'm not going to completely blame the nurse here because it all started with the physician who prescribed M&Ms for a vascular post op patient.

Gad, I need a drink.

Around 4 Pm today, I went to see Mr. Larger Than Life for a cookout at his house. My sister in law had told me earlier that his arm had been hurting and his finger tips were numb, but he'd adamantly refused to go to the hospital. He sat in his chair all day with a heating pad on his arm; he was convinced he'd pulled a muscle. When I got there, his arm was scarlet red from the first degree burn he gave himself from the heating pad and his fingertips were like ice. I told him if he didn't go to the emergency room, he was going to lose his arm. I've never seen him put his shoes on so fast. MLTL had a brachial artery embolus-a clot in the artery that feeds the lower arm. He had no pulses in the radial or ulnar arteries.

The ER staff was wonderful. The surgeon and OR staff who were called in were wonderful. The floor nurse was something else entirely. Another hour after ingesting the M&M pain medication, this man's arm was still throbbing. For 2 hours, I'd been been telling his nurse that the swelling, weak pulse and extreme pain were really not normal in her fresh post-op patient. She kept telling me that she didn't see anything wrong with the way it looked or felt. I finally looked at her and told her to call the doctor. It turns out that his vascular dressing was so tight it was cutting off circulation to his forearm and hand. Once the doctor released the dressing, his pulse became bounding and his hand immediately warmed. MLTL fell asleep.

As much as this man can be a thorn in my side, I abhor unnecessary human suffering. It's so cruel to know that relief is just around the corner, but because the secretary did not get the patient into the computer, he had to suffer. Ain't right.

He did make me laugh a bit though in his fresh post op and versed clouded state of mind. How his penis came up as a topic of discussion is beyond me. It could be that this was his way of telling us he needed to pee. Out of the blue he said "it used to be my pride and joy, but now it's just a watering tube." With the next breath, he asked if he could have a hot nurse. Ha. Not tonight, MLTL. Not tonight.

23 comments:

Pyzahn said...

Gosh, I was getting on steamed and worried, then you made me laugh with that comment from MLTL.

After living thru the poor treatment my father received in the hospital (don't get me started!), I made my friends promise if I was ever admitted they would set up a schedule and someone would be with me round the clock.

I want you on my team!

Kathleen said...

You ROCK, Rudee!!!!

I'm so glad MLTL had a lick of sense and listened to you.

Do you always nail your diagnoses like that?

Stephanie V said...

After going through the hospital system with my Dad, I know exactly what you mean. I was so grateful to have my sister - a nurse - right beside me. And, yeah, there are some really funny things happen on the way...
Glad MLTL is going to be all right. He's lucky to have you.

Miss 376 said...

Glad it's all turned out for the good. Good to have a bit of humour out of the situation too

Ruth said...

Patients need a advocate and that's what we nurses are supposed to be - so many times it dosen't happen due to maybe lack of knowledge, ignorance or just a bad nursing. I know which of my colleages I want looking after me and who i wouldn't if I was unwell.
Patients are at the mercy of nurses adn it dosne't take much really to get it horribly wrong or wonderfully right

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debra said...

If I am ever in the hospital, I am calling you, rudee! I think the lack of response is a complex problem, and an advocate 24/7 is really important. We felt we had to be just that with both my parents, except when they were in hospice care; we knew that they would be cared for there.

Hope MLTL is healing well and that his
watering tube continues to do it's job.

Queenmothermamaw said...

Boy you are right. A nurse's first job is patient advocate, your patient or your family member. Men beat all I have ever seen. They seem to think it is unmanly to admit to pain or illness. I liked this story, true but a touch of humor.
QMM

flydragon said...

Wow, I hope that Mr. Pain in Your Butt finally realizes just how lucky he is to have you in his family. Maybe now he won't be calling you or stopping over so early in the mornings:))

Rudee said...

Pyzahn-everyone needs an advocate in the hospital.

Kathleen & Stephanie-we were both lucky-me for figuring his problem out and him for listening to me. I didn't mince words and it frightened him into action. MLTL is always difficult. A one armed MLTL would be horrible.

Miss- the sedation they used made him very funny. I didn't know he had a sense of humor like that.

Ruth- you are right. Errors of omission can be as bad, or worse than errors of we commit. Active listening instead of struggling to let our knowledge base be heard can be a challenge. His nurse should have listened to him and tried to better assess his post op pain. After re-vascularizing a limb, there should be some relief of discomfort, not more.

Debra and QMM-it's all about the watering tube, even in illness.

Fly-he hasn't been by early in the morning since we moved. If I'd known 8 miles of separation was the answer, I'd have done it sooner. Looks like he won't be driving for a bit now, but by that, I really mean a very little bit.

Brenda said...

Your family is lucky to have you in their corner. And your patients also. Hope you had a nice weekend otherwise Rudee.
PS....men never forget about that part of their body. Ha...

Rudee said...

Brenda, Saturday was nice. Sunday, not so much. I haven't seen him today yet, but I hear he's back to himself. Busy barking orders, but at least he can point at a to-do list with two arms today. He'll not appreciate how close he came to losing it once he's completely well.

Jadekitty said...

He is very blessed to have you as his daughter in law. I'm glad you stand up for the patients, I've seen too many things go wrong, because of lack of care.

Djinn said...

Rudee,
Sorry he's not as appreciative as one ought to be.

Strong pain-in-the-butt nurses who advocate for the patient are a wonderful thing. I felt so mistreated by the hospital after my first baby, I insisted my mom (a strong pain-in-the-butt advocate, but not a nurse) be with me for the second. It wasn't to be, the baby came far too fast. I wish some one like you had been there both times.

Renie Burghardt said...

Well, like others have already said, your FIL is just lucky to have you in the family. And if I ever need nursing care, I'll send for you, Rudee!

Dang it's hot out there today!

Lisa L said...

wow rudee - excellent work on the diagnosos girl! and for being his advocat....thank god for you...

Winifred said...

Oh my that was a wonderful post Rudee.

I'd love to have you rooting for me in my corner if I ever need a nurse. Yes he must be a right royal pain in the bum but you're right it doesn't mean he should suffer. I love the humour at the end too. Brilliant. I'm sure men are obsessed ny their appendages!It would make a great sketch for a sit com.

SkippyMom said...

I won't allow our Grandmother or parents to go to the doctor hospital without someone with them - there has to be someone there to ask the questions you/they don't think to ask.

Nicely done Rudee. I am so glad you were with him.

Heather said...

You Go Rudee!

NCmountainwoman said...

He is one lucky man! Thank goodness you were there.

When my husband had surgery I was definitely the "wife you love to hate." I cannot tell you how many nurses I gently reminded to wash their hands before they touched my husband, or my husband's tubes. I also mentioned to a couple of them that alcohol handwash is not lotion.

Rositta said...

Rudee, I'd want you in my corner too, too bad you live in another country. I know all about post op pain but I got lucky with that, I had a morphine pump. What wasn't so great were the percocets I was given after. I'm glad MLTL is okay, thanks to you, he does give you some "fun" stuff to write about...ciao

bettyjf1 said...

Oh The end was pretty funny. You'd be the nurse I'd want for sure. As a too often patient, You would be the angel I'd always remember. MLTL is lucky to have you as his daughter in law

laurie said...

oh my god he is so lucky to know you. oh my god you are wonderful, skilled and kind.
and oh my god that last graf made me laugh.