|
Yesterday was supposed to be crazynurse's day of discharge to skilled nursing (this is the current polite term for "warehouse for old people") for rehab.
Notice the supposed to ...
I got an email from crazynurse's sister ...
Seems that PT came into crazynurse's room. The PT worker had NOT read her chart or ever met crazynurse.
The following conversation is a complete dramitization intended to enhance the absurdity of what happened
"Come on, Mrs. crazynurse, you're going down to PT, you've been there before."
"No, I've been flat on my back in this bed for the last thirty days. I haven't been down to PT at all."
"Sure you have. You just don't remember. You're old and you've been sick, and your memory obviously sucks. Can you tell me who the president is?"
With the assistance of two other idiots, the PT worker hauls crazynurse to her feet (which she can't feel) for the first time in thirty days.
crazynurse already has a REALLY LOW blood pressure.
When you suddenly stand someone up, stuff happens, including something called orthostatic hypotension. You've done this yourself by accident ... you know that headrush you get when you stand up too fast sometimes? That's your blood pressure bottoming out and oxygenated blood isn't making it into your brain.
Well ... when your blood pressure is ALREADY low, guess what happens ...
Crazynurse passed out.
And stopped breathing.
So they called a code.
And intubated her.
And got her up off the floor and back into her bed.
And put her on a vent and transferred her back to the ICU.
So, I get over there, arriving just after her family. Apparently she came to once on the vent. And tried to pull out the tube. So we know she's pretty much herself in there. They restrained her and knocked her out.
What she didn't have was a stroke ... once they knocked her out they scooted her down to CT, and her head didn't show any changes or abnormalities.
She has a lot of gunk in her lungs. Her left lung is completely opaque on the xray, and her right lung is filled up about halfway. So she's not moving air the way she should be.
Nurse comes in, says she's lightening the sedation because the doctors need to talk to her. They deemed her intact enough for informed consent, you see.
They give her a sharpie and a clipboard to write on for her end of the conversation.
First thing she writes? "AM I ALIVE?"
So, cluster of doctors is trying to explain what they want to do (which is to insert a tube directly into her lung to suck the gunk out and improve her breathing).
This is, however, not what the doctor says. I really think that foreign doctors should be required to take a course in communicating effectively in basic English. No alterations are made to the following conversation for dramatic purposes, it's absurd enough all on it's own
doctorgarble says ...
"crazynurse, you have tube in your mouth to breathe, we could put tube through your throat (and points at base of his neck). We want to put tube in chest to pull fluid from lung."
At this point crazynurse starts shaking her head back and forth, and her eyes are wide and scared-looking.
"but crazynurse, you need this"
Further conversation is fruitless.
We were told to be quiet and not interfere.
Yeah, like I'm able to do that.
So I raised my hand and did an "excuse me" cough.
"What we have here is a failure to communicate."
(I love saying that)
"Doctor, you scared the Hell out of her. She thinks you're trying to trach her."
"I didn't say that."
"No, you didn't use that word, but the way you started that's what she thinks you want."
crazynurse started pointing at me and giving a thumbs up ...
"See, that's why she's scared and keeps saying no. Crazynurse, they aren't going to trach you. They just want to shove a chest tube in you to suck out the crap in your lungs. Is that okay?"
Rapid nodding ensues.
"there's your consent."
Another doc comes in, checks her settings, orders a blood test and announces that if the results are good, they'll pull the vent and let her breathe on her own. He shut off the vent, but let it continue to supply oxygen, but only on her demand ... when she actually triggered the breaths herself, it wasn't pushing air into her.
About 45 minutes later, she was extubated.
First thing she says?
"wolf, you saved my life again. How did you know what I was scared about?"
"I could hear you thinking."
And that is why I am not in the mountains with my girlfriends this weekend.
|