It was International Nurses Day a week ago so I thought I’d use that neat segue to describe a scenario I’ve experienced when working on the wards, one I’m sure all nurses have faced at one point or another.
I had an elderly patient who’d recently had a hip replacement. The woman, let’s call her Ethel, was a delight. Patient, pleasant, cooperative. She smiled a lot and consequently I smiled a lot. A smiling patient can be a rare thing. Ethel, unfortunately, had to have a catheter post her surgery. More unfortunately, she developed a urinary tract infection.
A UTI is rather common, especially when you’re inserting foreign objects into someone’s bladder, and is treated with antibiotics. For most people it means a little pain and irritation. However, with elderly and frail people it can bring on delirium. Delirium is essentially a fast acting, short-term dementia. In other words, it sends the patient loopy.
Ethel transformed from the perfect patient into a terror.
Sunken deep in her delirium, Ethel held the belief that the hospital staff were holding her there against her will. In her eyes, we were her jailers. She let us know this with a rather impressive and expressive collection of profanity, as well as physical threats. While this made doing even the simplest thing for Ethel a great struggle, a part of me couldn’t help but admire Ethel’s fight. In her head we were the enemy; rather than laying back and taking her imprisonment, she chose to fight. And I mean fight.
Fists swung, feet kicked, and if you weren’t staying alert and got to close to her head, you ran the risk of being head-butted. Ethel was a warrior.
Because of Ethel’s UTI she had to have an intravenous infusion of antibiotics. Luckily she viewed her infusion favourably. Any attempt to touch her cannula was met with, “This is mine! You can’t have it. If you try and have it, it will poison you and you’ll die!” This was a much better reaction than distrusting her infusion and yanking out the cannula, which was the usual course of events in these situations.
One night we had hung her latest infusion. Any interaction left Ethel unsettled so we gave her fifteen minutes to calm down before checking her vital signs. When we returned we found Ethel asleep in her bed. This was brilliant. Her BP cuff was still circling her arm and all it took to measure her blood pressure was the push of a button. Checking her temperature, however, was a bit trickier.
We had a thermometer that had to be inserted into the ear and a button pushed. This sounds simple, but when a person is violent thrashing their head it’s hard to get an accurate reading. A sleeping Ethel was a blessing.
I tiptoed beside Ethel, carefully lowered the thermometer probe, and pushed the button. It beeps as you press it. Ethel woke instantly.
I jerked my hand away just in time to avoid the clacking of her teeth as she tried to bite me. Her eyes darted between me and the thermometer in my hands and understanding spread across her face. Her response was instantaneous.
“You little bitch,” she hissed.
I had to bite my lip to stop from laughing.
After three days of antibiotics, Ethel was back to her charming and lovely self. She had no memories of her delirium, which was for the best.
Despite her reversion back to the grandmotherly old dear, I couldn’t help but remember the warrior that lurked beneath. I was warily impressed.
The point of this story is that this scenario is just one of millions that combine to make what is a rather average day in a nurse’s work life. Threats, physical assault, stress over a patient’s health, juggling ten tasks as once, and trying to decipher medical orders are the hurdles a nurse is facing at any given point, be it day or night.
As you’re reading this there are nurses tending to wounds, bathing patients, administering injections, and stopping sweet old ladies from biting down on their wrists. It’s a strange job, a stressful one, and a rewarding one. And one that leaves you with a lot of stories.
Next time you’re in hospital, be nice to your nurse.
Please don’t bite them.