Nurse Jobs London

Our patients are not quite as critical as advertised, for the most part, but occasionally we’ll have one who’s pretty sick. Actually our sickest patient is chronic, and if she could get stable enough she really belongs in skilled care or maybe even rehab. She was in a horrible MVA last year sometime and she’s lucky to be alive, if you can call her current status living. She must have been in a bad T-bone crash; everything on the left side of her body was smashed. She was on the vent for an unconscionable amount of time and still has her trach. Had a PEG tube too when she arrived, but no longer does. An external fixator on her left humerus. Foley, of course. And naturally, decubiti from hell, including one I could probably lose my fist in. There’s a total of six dressings, but only two of them fall to my shift, being twice a day. The first time I did them it took me an hour. I’ve gotten faster and learned to combine the dressing changes with her bath, which means she gets cleaned up at an unearthly hour, but I’m not real sure she knows what time it is since she’s been in the hospital for so long. I suspect she also has a traumatic brain injury–how can you get that much of you smashed and not have one?–although some think she has ICU psychosis. Well, why not both? Anyway, after an initial period of circling each other cautiously, we seem to have come to a point of actually liking each other. At least she usually smiles at me when I come in, and I’m beginning to think we have similar senses of humor. One night when I had finished the worst of her dressings and rolled her back onto her back preparatory to doing the other, she looked at me and said “I need a drink!” I said “So do I!” and we both laughed fit to kill. She gave the nurses hell on Thursday, but when I came back Friday she seemed glad to see me. That does kind of make me feel good.

My apartment is sort of stuck right now until I can get some paycheck into it, so it looks like I’m still moving in. I think once I get my queen mattress in and can move into the master bedroom the puzzle will unlock. I’ve started on my garden, gotten it tilled at least, but lately it’s rained almost every day I’ve had off, and I can’t get the raised beds built, so all my plants are sitting in their containers on the patio. When I do manage to get it in, I’ll have tomatoes and peppers, green beans, greens, radishes, beets, cucumbers, eggplant.and sunflowers!

And now for a non-nursing note.this morning I got up and as usual while having my coffee perused various news sites from places I used to call home. Imagine my surprise when I saw this picture on both the local paper of my former home town AND a tv station website! The occasion was the dedication of a new veterans’ memorial for Iraq vets, of which my son is one. He’s the skinny guy on the right front of the pic. His name doesn’t get mentioned in the article, but I knew he was working on the project. It’s just like him to do the backstage work and let someone else do the talking (the husky dude on the left front, who is his best buddy in the guards). He can’t help being so photogenic! Am I proud of him? You bet.but I wish he hadn’t had to go, that one of the guys he worked with hadn’t encountered a roadside bomb and been permanently disabled, and that so many hadn’t been killed and wounded. Now his outfit is on alert again.dammit, somebody stop this insanity!!!
Anyway, here he is, my pride and joy.

As if that wasn’t enough, the patients I already had were very needy. One in particular, I shall call her Ms. S, who had end stage COPD (emphysema kind of stuff, for any non-medical types). I felt genuinely sorry for her in a lot of ways; she’d had breast cancer a few years back, and according to her, the chemo and radiation had basically caused her body to completely fall apart. The problem I had with her wasn’t going into her room, it was getting OUT. It just seemed there was always something *else* she needed, and she was in love with her call light.

Last weekend wasn’t nearly as bad.busy, but steady-busy, not insane-busy, at least for me. As the day nurse I traded off with said, “You couldn’t hand pick a better team.” There were the two guys I thought of as the Twin Tummies, with the same diagnosis, symptoms, and meds, just that one was 20 years older than the other and just a bit sicker. There was the lady with the mystery diagnosis, and I wonder if they ever figured out what it was. And then there were the assorted wheezers and coughers. But they were all nice, and nobody was crazy, more than I could say for some of the others.

One of my friends had Ms. S on Friday night and reported that she was going down fast. The lady had been a DNR but had rescinded it, much to the consternation of the nurses who saw which way things were going. I could sort of understand it.the lady wanted to go her own way, kicking and screaming.but she didn’t have much to work with, and we all knew that. Sometimes you’ll hear nurses say, “I’ll WALK to that code,” but when it comes right down to it we’re going to try just as hard to save that life as any other. And that’s what happened to Ms. S. Sometime on Saturday she went abruptly down the tubes and ended up in ICU with tubes down her. Around 2:30 Sunday morning a bunch of us were standing around the nurses’ station when “code blue, ICU B” was called overhead. We all looked at each other and more or less simultaneously said, “I wonder if that’s Ms. S?” It was, of course. Later on, at shift change, we heard that she actually coded three times and her husband made her a DNR again. As of then she was still hanging on, but she went later in the day. (I hope you found peace, Ms. S)