Monday, January 31, 2011

the virgin mollie: how to get saved!

"I'm a little high on NyQuil and Tramadol as I write, so feel free to edit," the Virgin Mollie starts her submission. We won't hold it against you, Mollie. 
You know how we're supposed to have scripted bits we use to talk with patients? I want to know why we haven't received this as a script, because I'm fucking using it. Thanks, VM!
This is a story about coming to Jesus.
I started my career as a floor nurse. There, on Satan's Li'l Tele Unit, I learned what is probably my most valuable nursing skill: the Come to Jesus Meeting. This is a one-sided conversation, during which I lay out for my patients why we're going to do things my way.  It's a sort of behavioral modification tool, where we---Patient and I---come to an understanding. Usually it is used for those who:
  • ride their call lights incessantly with the mistaken idea that their nurse = their bitch
  • have unreasonable expectations (only ordering chocolate cake on a diabetic diet, refusing to walk until done watching the Maury Povich rerun marathon)
  • have family members who believe, after careful research on Wikipedia, Facebook polls, and, that they know MORE about disease/pharmaceuticals/avoiding death than our staff.
Patient was typical of our clientele. He was angry at us for his illness, as if we "gave" him coronary artery disease ("Here's a lollipop for you, and here's coronary artery disease for you"). Since surgery, this patient had been a terror---he'd been on the unit nearly a week. He was the sort of patient that, during global report, was not referred to as "pleasant", "confused", or "cute" (code word for "batshit crazy". Bulldog, the weekend charge nurse, understands "cute" differently than most). I forget the exact terminology Bulldog did use, but it boiled down to "unpleasant".

Usually report and nursing assignments go quickly. "Good" patients are divvied up accordingly and the less intense ones are paired with a sicker patient. There was absolute silence this Saturday morning. No one wanted this guy. Finally, I spoke up: "I'll take him." A collective sigh of relief. 
Off I went to get report. I'd been working in the CVU for only three months, so I wasn't trusted with very sick patients at this point. Background on Patient: male, in his late 50s/early 60s; angry; smoker; drinker; had major heart surgery. Secondary complications of renal failure and constipation, and did I mention he was angry? Meanest motherfucker ever, by report. The offgoing RN gave me the rundown. He shared that Patient was a "one-shifter", meaning "after one shift of having him, you will want to kill him and possibly yourself to eliminate every possibility you might end up with him again".
Patient hit the call light. Ding, ding, ding, ding, ding. He was also loudly calling out, using a string of obscenities, for his nurse. Night RN finished his report and asked, "Do you want to go look at him (which, in our unit, means 'so I can show you anything abnormal/ interesting/etc' about him)?" He was a recent graduate; he just wanted to go home. 
"No, I got this," I said.
Patient's call light continued to ding. 

As soon as he saw me, Patient immediately launched into a tirade about his call light going off for more than 30 seconds, which was how soon he expected "the help" (me) to arrive. He then began to curse me at the top of his lungs and tell me everything that was wrong with me. I stepped inside his room, calmly shut the sliding door to his room, and drew the curtain.
"I only have to come in here once an hour," I informed him. 
"I am not your maid. I control the pain medications, the nausea medications, the benzodiazepines. Also, the stool softeners. You are at my mercy and I will be directing your care today. I will be polite to you and I expect you to be polite back. You will NOT be hateful to me, or to other nurses."
"HOLY SHIT," said his face. And he was saved. Jesus 1, Patient 0.
It was mentioned in report for several mornings that someone had done something to him and now he was actually being pleasant. Nah. I'm only an instrument of the Lord.

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