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Sunday night can best be summed up as “x out of 5″.as in: 3 out of 5 of my patients were DNR; 2 of 5 even knew who or where they were; 4 out of 5 were incontinent of poop, and that’s where my night went.

The patient admitted toward the end of the shift Saturday morning was still lingering, now on comfort measures only, with family sitting quietly in the room. I watched, fascinated, as her O2 saturation dipped to 71% and then 64%, though there wasn’t much change in her other vital signs. Surely she couldn’t last the night with that.but she was still there when I left. My lady from the nursing home Friday night was doing pretty well, responding to antibiotics, confused but pleasantly so, and thus no trouble at all. Then there was the other DNR, confused beyond belief, well-known to be a wanderer, and massively and odoriferously incontinent.multiple times. Compared to him, the dialysis patient next door, also incontinent, was nothing, because at least she didn’t holler and fight you when you were cleaning her up. And the guy who wanted his pain meds? Nothing to it, except that the docs were supposed to have changed him to oral meds so they could send him home Monday. (Guys? He can’t go home on IV Dilaudid for this problem!)

So that was my night.mass (mess?) confusion and cleanup. It could best be summed up by the occurrence at the end of it all when I was totally punchy. I was in with the aide cleaning up Mr. Stinky yet again. I was holding him rolled over towards me when he ripped a huge one. “That does it!” said the aide. “Next time I have to fart, I’m coming in HERE and doing it!”

I couldn’t help it. I lost it completely and we finished up both giggling like idiots.