Long ago and in another state, I worked on a med-surg floor of a famous hospital. At that time, patients waited in the hospital for nursing home beds to become available, a wait that could sometimes last a year or more. We had as a patient an elderly Spanish aristocrat I'll call Juan. Although Juan had been in the US for decades, a series of strokes had wiped out his command of the English language, along with most of his inhibitions and common sense. I'm pretty sure he was disoriented and confused, although without speaking Spanish it's difficult to know for sure. He had no family left, no friends, and no visitors. We the staff were his family. Sort of.
Juan was a little weary of living in the hospital, and it seems his fondest desire was to escape. And he tried. Often and unsuccessfully. In the end, we put him in a geriatric chair -- a chair with little tiny wheels so we could move it about, a tall back and a big tray on the front of it so you could serve meals or place items for distraction on it. And we put that chair in the nurse's station so someone could watch Juan. Only thing is, it was a very busy unit -- most of the patients were confused, incontinent and on Lactulose -- so the nurses weren't there to watch him. They were with other patients. Juan learned how to scoot that geri chair backward down the hall using only his tippy toes. The brakes, if there were any, no longer worked. And away he'd go.
I was there the night the nursing assistants decided to curb Juan's wandering by tying the geri chair to the sink in his room. I was passing meds down the hall when I heard the crash, followed by shouting, and I ran up the hall just in time to see water gushing from the hole in the wall where the sink USED to be. Juan was halfway out of the room, scooting backward in his chair with the chair still tied to the sink and the sink coming along for the ride.
I didn't win any points with the nurse manager when I was laughing too hard to explain how the "accident" happened.
It may have been my idea to tie Juan's geri chair to the handrail on the walls in the hallway. And for awhile, it worked. Everyone would stop and check on him when they passed him by in the hallway, and he thrived on the attention. This went on for a couple of weeks. But alas -- it was a new building and construction was shoddy. (Remember the sink?) It was late on a Monday night -- the night that the hooker habitually visited, claiming to be a relative, and for a small fee would take care of the needs of any long-term male patient who was interested and could afford her. Juan was sitting in the hall getting more and more agitated, but things were so busy no one stopped by to chat with him. We'd just check him quickly and move on.
I was passing meds a couple of rooms away, back toward Juan when I heard the crash and the shouting and screaming. Juan had succeeded in getting away despite being tied to the hand rail. There he was, scooting down the hall with only his tippy toes . . . dragging the handrail and a large chunk of dry wall with him. And there inside the wall, revealed through the gaping hole in the wall, was the hooker servicing her customer. Oh my.
I didn't win any more points with the nurse manager by starting to giggle every time the subject came up, and to laugh helplessly when trying to describe how (and why) it happened.
The memo came down from above -- no more tying Juan to anything that was supposedly stationary. We'd just have to watch him more carefully from now on. And watch him we did -- for a long time, we watched him. I caught him trying to roll his geri chair onto the freight elevator, and someone else caught him on the GYN-oncology unit, shopping for a Spanish speaking companion.
Juan's travels were permanently halted by a medical student from Man's Best Medical School. The MBMS student found Juan, securely Poseyed into his geri chair trying valiently to open the heavy fire door at the top of the stairs. Being a polite kind of guy, the student opened the fire door and held it for Juan so he could scoot the chair through the doorway. (Now why anyone would be stupid enough to do such a thing, I cannot imagine, and medical students -- even those from non-prestigious schools -- are supposed to be intelligent.) Juan scooted the chair backwards through the doorway, right to the head of the stairs and over the top step. Even I, at the nurse's station, could hear the "THUMP-THUMP-Thump-thumping" of the chair bumping down the series of steps. When I arrived at the top of the stairs, there was Juan, still strapped securely to the chair, lying on his back at the bottom of the stairs. The chair back protected his head, and Juan was shouting away in Spanish, seemingly unhurt and undaunted. But his back was broken.
If you think any of the previous incident reports were difficult to write, this one was a nightmare!
Several weeks later, Juan was back on our unit in a full body cast. But the fall had broken him. He could no longer propel his chair with his tippy toes, and a decub underneath the cast got infected. He got septic, coded and died. We staffed the unit with floats the day of his funeral and everybody went.
I still remember Juan and his geri chair fondly, and so help me there are times when I'm trying to tell that story and I laugh so hard I can't finish. To survive in nursing, you have to laugh instead of cry.
