I was in charge of reading this stuff once...

There are no tea leaves at the Hotel unless one of the nurses brings them in or someone tears up one of our fine no-name teabags.

However, rehab nurses, especially on certain shifts, get really good at reading the signs in stool.

Yes, as they taught you in school, color and consistency do matter.

Back to the old grind...

Let's be blunt...

Okay, sometimes as a rehab nurse, you have to do it.Using grandiose medical terms like micturition and defecation just don't cut it.

We have to ask "Did you pee lately? " (due to a variety of reasons) and "Did you have a bowel movement?"  Yes, nursing students, if you can't observe it, you have to get reports from your patients, and like those videos, you have to ask questions: color, consistency, etc.

We sometimes even resort to the old standby, especially for the really deaf hard-of-hearing folks, "SO-AND-SO (insert name here) DID YOU POOP LATELY?" This is always especially fun when the soundproofing is not so good in the exam room.

So, needless to say, since I have some of those old characters (many of whom don't hear well) as patients, I really enjoyed reading the headline below (which wouldn't surprise me if I heard it out of our folks..)

Michael Douglas: Oral sex caused my throat cancer (from the UK Guardian)

While Michael still needs some patient education, he may have already inferred something from the literature from the comments he made.

I just wonder how Catherine Zeta-Jones took it all when she picked up the paper.

More later...

Back to work and...

"She never gives out/She never gives in/She just changes her mind.
 She's always a woman to me."
 Billy Joel, She's Always a Woman to Me (The Stranger, 1977)

Q. is a character. A short, thin, sassy, color-coordinated one. So much so, that she put those color extensions in her hair to cheer up the patients. She put red and green in for Christmas. She put football team colors in during football season. Other colors for baseball. And there was always purple, because it is her favorite color.

Q's laugh, high-pitched and resounding, could be heard all over the unit. One regular patient told me, "I know Q's here whenever I come, because I hear her." She'd fly into a room and give patients she knew a big hug and tell them, "C'mon Mr./Ms. So-and-So, you need to get up and see those therapists. They're waiting for you."

She would also clean them up and get them ready for relatives, trips to x-ray, or only to roll out in their wheelchair or stretcher on the unit. She had her favorite patients, and she'd tell you who they were. She was known to negotiate to get the ones no one else wanted. And when she was done with them, they wanted her as their nurse every day.

One day, Q. told me in the hallway, when I was done with one of her patients appointments, "RehabRN, I really have a pain in my side." I told her, "Q, you'd better check that out. Don't hurt yourself."

In a couple of days, Q. was at work and she told one of the staff she was having chest pain. Since she didn't fit the profile of a heart attack victim, staff still worried about her because she didn't like to complain. R., the staff member she told, took her to the ED down the road, so she wouldn't have to go alone.

Q. got the workup and she didn't have a heart attack. She had terrible labs, though. By the time the weekend came, Q. got the news: she had cancer. She started treatment immediately. She went through a short rehab to get her well enough to go home, but she went downhill quickly. She was sent to World Renown for better treatments, but she didn't make it.

Today we found out Q. lost her battle. Her infectious laugh will never be heard again, nor will we see those crazy colors for the patients.

The Hotel Rehab will be pulling out the black bunting again.

You know you're a nurse when...

1. You get excited about dressing really horrible wounds. I like to consider myself the Queen of the WoundVAC since K. retired.

2. Input and output doesn't faze you.

3. Vomit? How much and what color, you ask.

4. And if the doc recommends this (as a transferring physician did recently), you know exactly what it is.

TGIS (or my last shift on evenings)

Thank goodness it's Sunday! Surprisingly, I won't have another evening this week after tonight, thanks to a good ol' Federal holiday...and then my regular day off. Hooray!

Things were quieter yesterday. They can be around holidays because the folks get either 1) lots of visitors and/or 2) lots of food, since we usually have visitors from every imaginable organization coming in to bring things to the veterans while they're with us during the holidays. We had balloons, we had a clown making balloon animals and we had food and candy everywhere. All the diabetics had higher than normal blood sugars from all the extra carbs.

One patient in particular was registering higher numbers than usual. We thought someone was feeding him all the goodies, but he said, "I think I'm getting sick." Whoa...what could be brewing? It should be interesting.

My patients were reasonably good, but I am wondering what will happen with DQ. Some strange things have been happening. One, he was quiet (but that was explainable--plenty of PRN Valium, which he admitted to enjoying.) and two, the NG tube secretions were brownish, but turning an odd color. The day staff tested them for occult blood, and while there was no coffee-ground emesis, it still doesn't look too good. The patient did have some drinks on his table of a similar color, so we made those disappear. We'll see if the color disappears with them. It hadn't by the time I left. It should be interesting to see what happens today.

My other patient complimented me on being on time for all the regularly scheduled turns. It was easy when DQ wasn't screaming or making a fuss.

Hopefully, tonight is peaceful and quiet, too. It won't bother me one bit! Stay tuned.