Sunday, June 28, 2009

O Dethmama, Where Is Thy Sting?

My absence from this site has been related to a sudden, but temporary, aversion to all things "bloggy" and unusually taxing work nights. I've truly felt the need to use every moment away from my hospice duties to tend to my physical and emotional well-being. That being said, let's take a peek at just a few of the events of my last "week" or so at work...

The Drunken Tuck-In

I went to a new patient's home to do a "tuck-in" visit. I was let into the apartment by the patient's friend who was putting away groceries that she'd bought for him and she'd also just picked him up from jail where he'd been detained on DUI charges.

My attempt to educate the man on his medications was completely thwarted due to his inability to pay attention to my learned advice. He was passed out drunk on the sofa and any attempts to rouse him were in vain. I notified the hospice of the situation, and predicted that "this new guy is gonna be a handful". For some odd reason, I feel that this is, so far, my Best Tuck-In Ever.

I Still Hate My Hospice's Pharmacy

Had a new admission into the inpatient unit for uncontrollable pain. The morphine drip didn't arrive until three hours after the patient arrived on the unit.
Got a call regarding a patient with intractable nausea and vomiting. The patient's caregiver has used every intervention/medication available to her and nothing's working for this poor man. I contacted our doc and called the new orders into the pharmacy. During my conversation with the pharmacist, I made it quite clear how much the patient was suffering. In spite of this, the pharmacist still asked, "Should we mail this medication to the patient?"

The Nursie Fight

I got into a shouting match over the phone with a nurse at one of our contracted inpatient units. She refused to go look for a patient's medications that had been sent to the wrong floor and insisted that our pharmacy redeliver the meds. Yeah, they were way too busy to look for those meds. So I flipped out.

I told her that I'd be happy to drive the 25 miles to look for the meds myself since her being inconvenienced was way more important than the patient's well-being. That pretty much got her panties in a bunch and she hung up on me... and I happily drove 25 miles to the inpatient unit.

Just Pick Up The Phone. Please.

I've tried repeatedly to contact the Administrator On-Call this week to notify her of potential shit storms and well, "nursie fights". She never answered the phone once.

It's Crazy Time

This poor, old woman has had a psychotic break. She's going to kill her son, her hired caregiver and then kill herself. As I speak to the son on the phone, I realize that he wants me to come over to the house. Apparently, he thinks that as soon as I walk in the door, his mother will see my heavenly halo, hear the angelic chorus and all will be well. I tell him to call 911 instead. He does.


I've attended nine deaths this week.

Drunken Tuck-In Redux

This guy's now in an inpatient unit for symptom control (i.e. keeping the pink elephants at bay). We need to work a bit harder on his situation. He's stumbling about the unit and wandering into other patients' rooms. The nurses are, understandably, not happy about this.

The Death of Michael Jackson

I found out about MJ's death from the 88 year old husband of a patient I visited on Thursday night. I was completely stunned and my arms broke out in goose flesh. The news also made me realize how "out of the loop" I've been for over a week. Okay, need to watch less BBC, more CNN.

Free Pepper Spray With Every Tuck-In

Both the patient and his partner were very pleasant and their tidy apartment was truly a place of sanctuary in this very, dangerous neighborhood. After making sure that the patient was settled in and his partner was comfortable with administering the new medications, it was time for me to go. The patient's partner would not let me leave the apartment, however, without first making sure that I was armed with a canister of pepper spray. Okay, this is officially, so far, the Best Tuck-In Ever.


Gia's Spot said...

Wow 9 deaths attended this week? I hope you have an ocean nearby to help reset yourself! You must be a fabulous person to have so many trust you with their dying. The tuck ins are funny in a sad, quirky kinda way! Thanks for coming back!

risaden said...

Glad you're back on blog-world. I've missed your rants. But agree with time outs for self-care.

Jessica Knapp said...

Wow. Take care of yourself. That sounds like an exhausting week! An entertaining update, as always, but you must tend to yourself first.

risaden said...

This post is featured in this month's Palliative Care Grand Rounds!