Queen of AMS

One of my fellow nurses was proclaimed Queen of AMS last night. All of her patients had some form of dementia. After about 12 hours of nonstop climbing out of bed, pulling off the cardiac monitor, trying to rip out the iv, trying to reason with the ramblings of four AMS patients; she too, was about to lose her mind. None of her patients were from nursing homes. They were your husband, wife, grandmother, or grandfather that functioned "independently" in society. Makes me wonder.........how many people are stumbling around at 2am in their homes, or worse yet, driving down the road, out of their friggin' minds? Also, none of the aforementioned patients had any family with them in the deep part of the night. Perhaps, the family was breathing a collective sigh of relief and enjoying the the night off.

Speaking of family, how many of us in nursing have found that some of the family members are more demented than the patient? My demented patient had a wife that was as bad or worse than he. The man and his wife were transplants, having moved down here in retirement for the warmer climate. The man was in awful shape. He was emaciated, covered in dried poo, and speckled with dribbled urine when he came in. Somehow, his half blind, nut of a wife drove up to visit him daily to rant and rave at the dayshift about getting her hubby out of the hospital and back home where she could take care of him right. The family doc evidently used the nice guy approach, the don't rock the boat, just get them out of here asap way. His H&P started out speaking of a "well nourished male" (who the heck was that?). The doctor was told, but he seemed to have overlooked the fact that the patient was demented, covered in feces and urine on arrival, continued to be incontinent of stool and urine while in the hospital. In addition, the man was one big skin lesion after another and no there again the canned H+P sounded like the man had the skin of a healthy baby. I probably started some stuff but I dropped a social worker consult for neglect. And note to self, don't ever use this doc for me or my family...He has his head up his ass.

pooh brown out

It was pooh night at work the other night. We had the Cdiff, gown and scrub code brown going on in one room, then lactulose for the high ammonia level in the alcoholic hepatitis patient in another room and you know what that means...pooh party. Then we had the chronic diarrhea going on in room 3, but at least she asked for the bedpan each time. Just for added amusement, in case we didn't have enough code browns going on, we had our obese, diabetic, renal failure patient that also shit all over herself several times per shift. This was a bit irritating because she suffered from that hospitalitis form of paralysis where she couldn't/wouldn't lift a finger to hit the call bell to ask for a bedpan before. She'd say, you weren't in here and I waited and waited but then I had to go. But she could hit the callbell after she went and wanted to be cleaned up, or when she wanted a snack. The way things were going, I figured our next admit would be a hyperkalemia patient that needed kayexalate. We were up to our asses and elbows in pooh all night. Nights like this make me wonder why I went back to school late in life and got my BSN. Just shoot me.

dumpin Grandma off

I worked last night so I'm a little brain drained this am. But I wanted to write about people who take their dear ole Grandma off to the hospital and leave her alone at night. There's probably a good dozen of the nice family milling around and demanding stuff during the day for dear ole Grandma. But at night, it's just her and me, plus the rest of her newfound family of nurses. I had one such patient last night. For the most part she was alert but at times her evil twin, Dementia, showed her ugly head. This little lady was 91 years old, all of 4 ft tall, and she didn't sleep a wink all night. "I want to sit up, I want to stand up, I want in the chair, I'm ready to get back in bed. I have to pee (has a foley) and I'm gonna pee all over this bed in a minute. I got to take a shit now. I'll shit everywhere! Where's my daughter? I know I heard her talking out there. Hey you, Nurse, come help me. I have to get up. I'm ready to go home" This went on for 12 hours. We even tried to put her in a cardiac chairs and out in the nurses area so she could sit with us. She was a cute little old lady, a real pistal, and a pain in the ass. We didn't restrain her but she kept us running into the room all night. And she got absolutely no rest. This is the 2nd night she has been with us and I am told she did the same on the first night. The dayshift nurses even asked if someone from the family could stay with her. What kind of people leave their 91 year old, demented mother by herself at night in a big hospital?

man of the month club

Hmmmmm. First real blog posting. I've done some myspace blogging but this is my first venture onto a real bloggers site. Previously, because my id was linked to my posts, my really gutsy, put it all out there, rants and cries were heavily edited. I'm going to let loose on here. I'm doing this blog for my sanity. I have not shared this blog site with any family or friends. It's gonna be a free for all. I thought about calling it Muffy's rage journal but thats taken.
Recently, I seem to have become a full fledged member of the man of the month club. I haven't found one yet worth keeping around or maybe one hasn't found me to be up to the challenge either. Online dating can be brutal. You wouldn't believe what some guys will say to you online. From what I understand from some of the guys I've met, the online women can be just as cruel. I guess it's easier to be cold and blunt when you are not face to face. I used to think I had no baggage from my previous relationships. Well, I've picked up a few carry-ons since I started dating online.

(awesome pic is from the movie Silent Hill)