Sunday, July 23, 2006

The Funniest Thing I Have Ever Seen



This is a picture of the beautiful Monterey Bay. It is about 30 minutes from Salinas, we go to there to the coast as much as possible. Which isn't really a whole lot when you work 4 twelve hour shifts a week. It doesn't sound like much but it doesn't leave a whole lot of time off, plus I'm tired. The work really isn't difficult here, I would stay a little longer if we didn't live in Salinas.
So, the search is really on now for my next assignment. I have spoken to about 7 different companies and am down to 2. Nursechoice has an opening in Glendale AZ which is close to my nephew and Agostini (who I am with now) has an opening in Ventura and Oxnard...they don't pay as much but the weather is better...we'll see what happens.
Now, for the heading of the blog...I have to set the stage .I was taking over a patient from an 8 hour nurse who was leaving at 3pm. His diagnosis was rule out CVA .He had been admitted 2 days earlier with confusion. The day before they had discontinued his IV, and his foley catheter.The CVA had been ruled out and his confusion had cleared, so the off going nurse said. He was still on the heart monitor, so I glanced at it while she was giving me report...his heart rate was 125. Already, I'm skeptical, we go in to assess him and his face is flushed and he is definitely not oriented to person, place and time, but he has a history of alzheimers so I wasn't too surprised. I checked his vitals and his temp is 102.3, heart rate 125 but it was sinus tach so it could have been just from his temp. His b/p was 168/94. Ok, what a great way to start the second half of my shift. Luckily the resident was still on the unit so we got some orders. I got an IV started and gave him a bolus, portable chest x-ray was done as well as blood cultures x2 and a CBC and CMP. I also did a straight cath for a UA and C&S. His heart rate continued to be 120-135 despite tylenol and a bolus of 250cc then 500cc. He had no cardiac history so, I wasn't worried about fluid overload. His urine looked pretty cloudy though. So, unfortunately when I left that night his heart rate was still elevated but he felt better and didn't look as sick. The next morning he was again my patient. He had been straight cathed a second time on the night shift because the lab had miss placed my first sample. I went to check on him after his breakfast tray was served and that's when it happened. I swear it happened, I'm not making it up. I walked into the room and he had his sheets pulled down past his waist and he's holding something. He says to me "How do I drain this?" He's holding his penis in one hand and his bendy drinking straw is coming out of his urethra like a little periscope....I almost lost it...what would you have done? I want to know...how do you handle this situation? Next blog I will tell you how I handled it...I should have taken a picture...because I know some of you don't believe me. My guess is he paid attention the day before when he got cathed twice. Reality can be so much funnier than fiction. I do love my job....remember first do no harm.

1 comment:

GingerJar said...

Well, haven't had a patient do this...but when I worked at the prison (Texas) an inmate on ad-seg couldn't get security to bring him to the clinic...and he couldn't pee (kidney stone or some other obstruction apparently) and he straigh cathed himself with the outside part of a "bic" inkpin. Worked just fine...always wondered if he wound up with an infection? Debby