Monday, March 21, 2005

Genuine Appreciation

This was years ago: nurse G. quietly asked me to come help him and nurse K. with a patient.

We walked down the hall to the room to find the patient on the floor next to her specialty bed. That particular kind of bed had pretty low siderails, and when little nurse K. had rolled the patient over to clean up a mess of incontinent stool, the patient just kept rolling. Her own body weight (she was quite obese,) gave her the momentum to just go over the rails and K. couldn't stop her.

It took about five of us to get her flaccid and heavy (near 300 lbs.) body onto a rigid backboard to lift her back into bed.

Her urinary catheter got pulled out, and while K. reinserted it, G. and I each had to hold up a fat leg out of the way so K. could see where to insert the new one. How come they never show things like that on TV medical shows?

That particular patient was a controversial one. She was irreversibly vegetative. After suffering a heart attack, she stopped breathing long enough to have suffered immense brain damage. But the family members remained completely in denial about her condition, despite repeated demonstrations from the doctors that she was vegetative.

She stayed at that hospital for the better part of a year. Though there were times when she was able to maintain breathing on her own (such as when she fell out of that bed,) there were also weeks when she had to be put on a ventilator. The medical staff wanted to pull the plug, as did administrative staff. Family refused.

Family also refused to have her moved to a facility that cared for long-term ventilator-dependent patients, because that would be "too far away."

The patient was uninsured.

Anyways, we didn't want the whole place to know that the patient fell on the floor. Of course the proper incident form and doctor notifications were done, but we didn't shout it to the world. It seems safe to discuss it now, under anonymity. And the accident luckily caused no injury, not even a bruise.

There were weeks when I myself was assigned this woman. I never, ever saw a voluntary movement nor any indication at all that she was in the least aware of anything. Doll's eyes.

What blew my mind the most about the family would be when they trotted in the children to "talk to grandmaw." The adults would go on talking to one another about "how good she looks" doting on every flicker as a response to their chatter, while the kids looked at each other, and at me, like their parents were nuts.

The poor children were quite obviously totally creeped out, but the adults were in denial about that too, commenting on "how much the grandchildren like seeing their grandmaw at the hospital."

Yes, they did pronounce it "maw," to my ears.

Though she was brain dead, her bowels worked just fine, and tube-feedings can encourage rather loose movements. The adults saw this as an angelic sign of "life" and they would chuckle and congratulate her on "making a good one" as they hopped out of the room, leaving nursing staff to deal with the clean-up.

It was as if, without irony, they thought she crapped all over herself just to show them how much she genuinely appreciated them being there.

The kids looked particularly freaked about that. Scared and disgusted, but glad to be leaving the room.

Bedbaths would take several people, because nobody on nursing staff wanted to have to pick her up off the floor again, should she have rolled out of bed. And it was easier to clean her if somebody else was holding a heavy buttcheek up out of the way.

Eventually the woman was transferred, against family wishes, to a long-term-ventilator facility hours away in a different state; a state in which the facility could get reimbursement for her care.

The hospital itself went financially back into the black the following year.

1 comment:

Anonymous said...

I was disgusted at the way you referred to this woman. She is someone's grandmother, friend, mother, wife. What you said was true.I have been there and done exactly what you did but you are cold and wrote about this in the most uncaring manner. As a nurse I am disappointed.