Nurses

A lot of you already know this, and I suspected that it was true, but this has been my first opportunity to see firsthand that nurses are fantastic people. The nurses on this unit (and my previous one) are on 12-hour shifts, so I have had quite a few in my three weeks here. Young and old, male and female, from all over the world -- each, in his or her own way, friendly, caring, reassuring. Despite the occasionally dignity-robbing details of hospital life -- Tuesdays are Fecal Swab Day! -- they are good at maintaining patient dignity.

Nurses have different relationships with the hospital. There are staff nurses permanently affiliated with the hospital, traveling nurses who affiliate with a hospital for some period of time and then move on to another, and agency nurses who fill nursing gaps as needed. Staff nurses have priority over traveling nurses, who have priority over agency nurses, so the night shift has a higher proportion of traveling and agency nurses.

Today, as the Blizzard of the Century shuts down Chicago, the nurses are preparing to be hospital-bound for a day or two or three, working even longer shifts to make up for the staff that can't make it to the hospital. And they seem pretty upbeat about it -- this is what has to be done to take care of patients, so that's what they'll do. (I can hear the wind howling outside, and the building is creaking under the force of the wind.)

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The level of nursing care has been so good that the one exception took me by surprise. She was an older nurse, a new face (to me), and she came into my room as the evening shift was starting, to introduce herself. Unlike any of the other nurses, she was wearing a yellow isolation gown. I knew that some patients were so vulnerable that anyone entering their rooms needed to wear these gowns, and my first thought was that I had entered that category. No, she reassured me, she just liked to be extra careful. That works for me!

A little later, she came in to disconnect me from Ivy so that I could take a shower. (We are pretty much hooked up 24/7 again, since I started a course of antibiotics last week on Fever/Vomit Day.) Besides disconnecting, preparing for a shower also involves putting the three lumens of my Hickman Triple Lumen into a plastic bag and then taping the bag over the dressing that covers the entry point into my chest. She didn't seem clear on the process, but I walked her through it. When she was done, I realized she hadn't worn gloves, and I had a feeling that nurses always wore gloves when working with my IV lines. Maybe it wasn't as important when disconnecting...

The Hickman Triple Lumen, bagged for a shower.

After my shower, I called her back to reconnect me. I was relieved to see she had gloves and wipes. That relief was short-lived. She had trouble opening the little packets containing the wipes, didn't fully unfold the wipes, dropped one of the wipes... I made her redo some of the disinfecting of the connectors, because the first pass seemed like going through the motions. I noticed that she was wearing large gloves even though she had small hands. This meant she had long flaps dangling off the ends of her fingers, which I thought might explain why she was having trouble holding things. I told her that if she needed smaller gloves, there were three boxes, in different sizes, mounted right inside my door. She explained that she wore the large gloves because her rheumatoid arthritis was so bad that she couldn't put on the gloves that fit. Arthritis! That explained a lot. Her hands were preventing her from doing her job, and I knew she (anyone) would have a hard time recognizing and accepting that. 

As soon as she left, I hit the call button on my multipurpose remote control -- call, light, TV on/off, volume, channel up/down, and caption and radio buttons that remain mysterious to me. "How can I help you?" "May I speak with the charge nurse?"

The charge nurse came right in. I recounted my experience so far with the nurse who had been assigned to me, how inconsistent that experience had been with the rest of my nursing care, and how uncomfortable it made me. I noticed that my voice was shaking. "Would you be more comfortable if someone else took care of you for the rest of the night?" Absolutely. (Though I'm nervous for any other patients in her care.) The charge nurse said she would take over my care for the night and talk with my (now) ex-nurse, who was an agency nurse and therefore not known to her. I learned the next day that this nurse will not be back.

I want to thank all the friends who have stressed the importance of looking out for yourself and dealing with anything that makes you uncomfortable about your care, as well as making sure I knew that my greatest risk right now is infection due to faulty care. Without that priming, I'm not sure I would have called out my nurse. Ideally, I would have stopped her the instant I saw her having trouble with her fine motor skills, but it took me a little while to process what was going on and stir myself to action. If there's a next time, I think I'll be ready.