Saturday, December 30, 2006

A funny thing happened today....

Well, okay, every day is an adventure. But - boy howdy - today just about took the cake and smeared it all over me.
For starters, our little 18-bed unit had been operating at 1/3 to 1/2 capacity for the past few weeks. Thus, I was allowed a few PTO days, while a few unlucky souls had to float to other floors. Suckers.
Suddenly, wham-pow!, we were slammed with 6 admissions on the second shift yesterday. One discharge today, and two more admissions this morning. I ended up working 12 hours (unscheduled) just to try to fill in the gaps and tie up loose ends. I didn't *have* to, I'm just a team player. With a cash flow problem. ::grin::
So, as the chaos commenced, we borrowed another RN from our sister unit, and the (covering) attending took a deep, ragged breath as we began rounds. Phones ringing off the hook, 4 or five lines in use/on hold at a time. Unit clerk slowly losing her grip. Dementia patients getting into their usual mischief. Manic patients slightly more escalated than we'd prefer. Younger "gero" patients that belong down on the adult unit becoming unglued at the aforementioned dementia patients. Oh, yeah, and I'm attempting to quit smoking. 'scuse me doc... but that brick wall with my forehead imprint? Yeah. Can ya hook me up with sumthin'?
UC slams the phone down and comes storming out of the dining room. I ask "who's that?" at the very moment she's exclaiming "Jesus Christ!" Without missing a beat I look shocked and ask if *he's* here now, too? She said Yes, and he wants an ativan. Raucous laughter ensued.
You just had to be there.
Good times.
Today's top contenders for causing Julie's meltdown:
Behind door number one, we have 400lb neglected woman whose daughter is lodged downstairs (the other psych unit), and unfit family members #3, 4 and 7 all wish to take over DPOA. One such transgendered individual showed up waving a 'legal' document that he/she insisted mom needed to sign TODAY. Sorry, bud(ette), but that just ain't gonna fly in the courts. *We* aren't going to witness the signatures, the notary isn't going to get involved, and there is the little issue of an inpatient committal that defers the patient from making such decisions when they are not operating at full cognitive capacity. Buh bye.
Behind door number two we have... oh who am I kidding. Wearing a path in the carpeted halls is pacer number #2 who is withdrawing from morphine for chronic neck and back pain and really really really wants his xanax right now at home I usually take it at 5am and noon and three and at bedtime or supper depending on how wound up I am so can you please change those inconvenient times that are standard hospital protocol for me because I really am kinda worked up in case you couldn't tell.
Number three is a sweet little old lady with an incredible swearing vocabulary whose family insists was a church-going saint until dad died a few years ago. This year she has begun wandering away from home, and doesn't recognize any of them. A nursing home is out.of.the.question. Why, mom only set the house on fire that one time. And she hasn't fallen yet. Why can't she continue living in the only home she's ever known? Never mind she isn't sure where the bathroom is. They've been utilizing their vacation from mom doing Valuable Internet Research on DAT. Because that's what one friendly nurse told them she had. How can you say she has Alzheimer's? they wail. We challenge that diagnosis based on hours spent googling the signs and symptoms and onset and our own personal denial. One Loving Granddaughter went so far as to tell the doctor that he's "just guessing", because *everybody* knows that Alzheimer's can only be diagnosed on autopsy. Stupid doctors. All those years spent at Harvard, and this is the best they can do? She went on to tell us that if gramma really does have it, then they need to know RIGHT NOW so they can all be checked out. Because it is "generic". Oh, and by the way... while she's here, we want an endocrinology consult to address her hypoglycemia, a "nerve-ologist" to check her out, and a podiatrist to cut her toenails.
You want fries with that?
At the end of the day, I am thanked by my co-workers for helping hold it all together, one nice family lauded me for being sensitive and kind (!), and my husband asked what I planned to make for dinner.
Thank you notes to Tide and Hefty.