Yes, I've been having that conversation with patients a lot lately. Maybe it has something to do with the sleeping pills. Otherwise, it just seems that people are a little more apt to talk about certain things when the sun goes down.
First, one of our guys keeps dreaming he's not sleeping at night. Yes, every time someone rounds on him, he's snoring and doesn't wake to calls of his name, but he swears to the docs that he's been up all night. Sure, they say Ambien can be a factor in sleepwalking, but for our non-ambulatory folks, I guess it could make the dreams seem as if they're awake all night. And, as you know, the patient is always right, just like the customer, until proven otherwise.
So what does that mean for us? More charting. Order that reads, "chart all times patient is awake at night." Nice.
Next, another guy, a fellow Ambien user, who never goes to bed earlier than 0300 anyway, was telling me about his dreams before he was injured: the new Harley that never was, the job offer that disintegrated, the house. He's working on some new stuff, now, since he'll be leaving us soon and going back to the area where he grew up. And he's hoping to make some of his new dreams come true. We're all excitedly crossing our fingers, since he's got everything set up for success.
Another guy seemed like he was dreaming, but he wasn't. He's going to leave us soon and he was just bawling his eyes out when I went into the room recently. Not because he's leaving right away, but that he's an old softie for a spot in one of these old movies they tend to show around Easter on TV. "Every time I see this, it gets me," he said between sniffles.
Finally, the nursing staff has a few dreams, too. Lots and lots of people are dreaming of vacation as the spring hits and summer is on its way. I'm dreaming of passing my certification and GRE exams before summer, since after that, it will be a long time before I get any more vacation. However, I do believe that we need to dream. It keeps you going.
To accomplish great things, we must not only act, but also dream; not only plan, but also believe. Anatole France
And so I go...to work again. More later...
3 comments:
Wow. What a great post! Rehab folks are awesome. It isn't often that we ER RNs get a glimpse of what happens to the people we send to you. Thanks for the work you do.
Thanks, man!
We were all freaking out recently when an EMS guy put an IO in one of our people who coded.
I've only heard of interosseous access in books, but here they were doing it on our unit.
Poor patient didn't make it, but did they try. It was sad.
Once a year is enough for us. (That's about our average, but this was our third code of the month). Dying on a rehab floor without the benefit of an ER or ICU nearby really sucks!
The debate over sleep is new and bizarre for me. For example, pt pages me for nausea. Said patient has already had enough narcs to kill an elephant, plus 10 mg of Ambien. By the time I return with the syringe of Zofran, patient is slack-jawed and not arousable by my whispered, "Mrs. X? Are you asleep?" Later: "I've been lying here for HOURS dry-heaving because you FORGOT my medicine!" But if I wake 'em up to give 'em meds, they're bitter about that too...I can't tell yet what course to take. Anyway it does happen a lot that I hear "I didn't sleep all night" when I have rounded every hour plus been in for several vitals checks and know good and well the person was out cold almost all night...
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