Heard on the unit...

Aw, it's been forever since I've had enough goodies for this segment! But when patients speak, sometimes we just bite our tongues and run as fast as we can to our lunch break, so we can share with the rest of the folks on the unit and with the audience at home.

Situation 1

RN is educating patient about the proper way to use an incentive spirometer. After demonstrating proper technique, patient says, "Oh, that's just like what I do at home with my bong." RN listens as patient describes how marijuana "relaxes my legs so I can get into my chair."

Sorry, remember that non-smoking thing you signed to come here for rehab? Yep, it applies to Mary Jane, too.

Situation 2

RN is talking to patient re: helping himself (He's a lower level thoracic paraplegic, so he can do it) by dressing and turning himself. "Oh, I'm not going to do that (turning) at home. I'll just wake her up." (implying whatever woman happens to be in his bed.)

Nice. My reply, "So since Babe #1 is not here, could you just move the pillows and turn yourself, please?"

Situation 3

From patient who is not really observant about following his intermittent catheterization rules or fluid restrictions.

"Where's my nurse? I missed my appointment." says Mr. Drinks-A-Lot.
"What appointment?" I asked.
"My catheter appointment. I've got a headache."
"Yes," I replied, "and you realize this is a sign of dysreflexia, correct?"
Patient shakes head.

If only Tom and Ray were here to do this...more to come...eventually!

No truer words

"nursing is head on, hands on, heart on. all together. all at once. maybe that is enough explanation why there is a nursing shortage. it is because not a lot of people can be all that, all at once."
--may at www.aboutanurse.com

If you haven't already discovered may's aboutanurse blog, do not pass go, do not collect $200, go straight there. I have been reading it for quite a while (I know I started in nursing school) and there is always something to think about.

My evenings are over for this week. Thankfully, everything went reasonably well. I had the same guys all five days and everyone was doing well. Mr. H. got in the shower, not once, but twice. I also let him know that M., our charge nurse, will get him there, too, if he wants to shower when she works, since M. does not rotate shifts like me. Mr. H. is a para amputee, but M is known on the unit for getting quads up and in the shower. Mr. B. was her longtime customer every Friday night until he left. Consequently, Mr. H.has been in a pleasant mood. I really think the showering is doing him a lot of good.

Mr. O., his roommate, is reasonably new. He's one of our few rehab patients. He's got a balky bladder, due to some previous cancer history, so I've been working on the rationale (aka sales pitch) for intermittent catheterization with him. He's been balky with some of the other nurses, so I go in and tell him very nicely and slowly how important it is that he empty his bladder. So far, he's agreed to cath more than he's refused. I cathed him, not once, but twice last night. Hopefully, they can get him on a schedule and just do it until he can get his urodynamics study.

The man across the hall, Mr. B. is still on C diff precautions and still has that foul, smelling stool. He is eating better (mostly Taco Bell, but he's actually eating other stuff with that), but we really have to sell him on drinking water. He drinks almost no water during the day when he has visitors (sometimes 20+ people), because when I was checking him on first rounds, his urine was always dark. By the end of the night, when I'd encourage the fluids and he'd drink them, it would get lighter. Who said nursing wasn't a sales job? I do a lot of encouragement and followup to get people to do what they need to do to succeed at the program. His halo is intact, but still causing him pain, so until the C diff stooling stops, we can't try getting him up into a chair.

I'm going to stop here...so many things to do in a short time on this day off. More later...