Tuesday, April 19, 2016

Why Nursing Is Stressful, Part 2


[A hospital examination room. The PATIENT, a woman in her twenties wearing a hospital gown, lies on the stretcher. Her MOTHER is seated in a chair nearby. ]

[Enter a NURSE.]

Nurse: All right, miss. As the doctor explained, your CT scan showed that you have acute appendicitis, so you need to have surgery right away. The surgeon is on his way and everything will be ready soon. Do you have any questions?

Patient: Yeah. Can you bring me a turkey sandwich?

Nurse: No. Nothing by mouth before surgery.

Patient: What do you mean, "no?"

Nurse: Your stomach has to be empty. It's an important safety issue. You cannot have anything to eat or drink until after the surgery.

Patient: Then can I have some crackers?

Nurse: No. Nothing to eat or drink.

Patient: How about some orange juice?

Nurse: No. Nothing at all to eat or drink.

Patient's Mother:  What if I go get her something from McDonald's?

Nurse: Still no. That would still be eating, and as I just said, eating is what she cannot do. She must not eat or drink anything of any kind.

Patient: All right, I guess I'll just suck on ice chips.

Nurse: No ice either. Nothing at all.

Patient: What about just a snack?

Nurse: No! Nothing! Absolutely nothing to eat or drink at all. Nothing. No food, no drinks, no ice, nothing. Nothing. Your stomach has to be empty. It's a very important safety issue. If there is anything in your stomach, you could vomit during surgery, and the stomach acid can get into your lungs. That is extremely dangerous and can kill you. We want you to stay alive. So, you must not eat or drink anything at all, starting now, until after the surgery. Do you understand?

Patient: I guess.

Nurse: Could you repeat what I just said?

Patient: I won't eat or drink anything.

Nurse: Thank you. Now, I need to go check on something. I'll be back in a little while.

[Exit NURSE]

. . . 


[The same hospital room. The PATIENT is now sitting up, with her back to the door. The wall clock shows that THIRTY MINUTES have passed. 

[Enter the NURSE]

Nurse: Good news! The operating room is ready, so I'm going to take you to... wait. What are you doing?

[The PATIENT turns around. She is holding a McDonald's bag. Her mouth is full.]

Patient: [mumbling] Whup you meem?

Nurse: I said not to eat anything!

Patient: [mumbling] I'm nomp eeping amyfffig.

Nurse: Yes, you are! I am standing here looking right at you. Your mouth is full, and I can see the hamburger in your hand. It's right there.

[The PATIENT shoves the last piece of hamburger into her mouth, chews rapidly, and swallows.]

Patient: I said I'm not eating anything!

Nurse: Please wait here. I need to go call a surgeon and get yelled at.

Patient: But I said I didn't eat anything.

Nurse: You've got ketchup on your face.

[Exit NURSE]

Friday, March 18, 2016

Compassionate Delegation

One of my patients this week was a small baby with a high fever. Since she was too fussy to accept anything by mouth, the doctor prescribed a Tylenol suppository. I got the med from pharmacy, then went to the travelling float nurse who was working with me that night, and asked her to administer it to the patient.

She scoffed at me. "What's the matter? Scared of a little baby poop? You can't go trying to push off the scut work on me just because I'm from the float pool. I'm sure you've given suppositories before. Don't ask me to do your work for you."

I said, "No, of course not. That's not the issue. It's just that I wear size 8.5 gloves."

She thought about that for a minute. Then she went and gave the Tylenol.