Saturday, July 30, 2011

Nighttime Events

Yesterday, because of the construction, the census on U8 was low and I was expecting to get called off. Rather, another unit needed an aide so I floated down to the JD Rehab Center, a subacute care wing of the hospital.

I arrived to find Andrea, an ICU nurse, had been borrowed too. Andrea and I have worked together many times and have become friends. We laughed together as the night began because it was a vacation; most of her patients didn't even take medications and many of mine were independent.

Ironically, I wasn't allowed to do anything but task, no charting, testing glucose or vitals because I'm not a certified nursing assistant. So my responsibilities were minimal. After the last few months of juggling both the responsibilities of an aide and unit secretary, this was refreshing. Andrea teased incessantly, tickled by my certification limitations. She thought it was a riot and would demand proof that I was qualified to carry a dinner tray or empty linen carts.

The night dragged painfully though. After what would have been a double upstairs, the clock read only 3 hours into the shift on JDR.

Then the fall occurred. Apparently, the family of Grandma Smith* had unplugged her bed alarm while they were visiting. Its shrill beep was annoying to them. After they left without resetting it, 94yr Granny Smith decided to go to the bathroom to change. We found her crying for help in a pool of blood and vomit.

Andrea and I kicked into gear like Emil Fischer's lock and key enzymes. She checked vitals and stabilized her head while I went to the desk to call a rapid response team and the ED for a lift board, cervical collar and stretcher.

The nursing staff on JDR is amazing. They're friendly, good with patients and very good at their job. They don't have many medical emergencies there though and so seemed grateful to step back to let Andrea and I take control.

The residents, newly minted PGY1 and PGY2, examined her pupils, spoke with their attending and down we went to CT. I stayed at Gran's head, pushing the stretcher with one hand and holding the emesis basin with the other. When she would get sick, I would stop the stretcher, we would slowly angle the lift board and let her vomit on her side. Her wide eyes locked with mine and she held my hand tightly. I know that she was frightened by the fall and the rapid conversations flying over her head. I wasn't really needed in the medical part of the emergency other than as a strong back so I tried to keep a constant gentle flow of words to only her to give her something to focus on. I explained everything that they were doing before they did it and her breathing slowed and deepened.

We took her to CT, then XRAY and back to her room. She settled in quickly. Andrea dressed the wound on the back of her head and I swabbed her mouth out, washed the blood and vomit off her face and shoulders and changed her gown. She even laughed at some of my lame jokes. "What did one snowman say to the other?**" Then I stepped aside and let the CNA test her blood sugar.

*not Mrs. Smith real name. Also many details have been changed to protect her, or his?, identity and the identity of my medical institution.

**answer to really lame joke: "do you smell carrots?"

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