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Bat Lady

Bat Lady

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  1. Bat Lady

    Denying Death As A Society

    Wow. I have been on so many sides of this in my career. I've had two nursing home patients in different hospitals who were intubated against their wishes, one because the EMS in that community *routinely* intubated all the "found down" patients they were called for (this was a long time ago), the other because the nursing home conveniently "couldn't find" the patient's DNR orders and she had no family to confirm them (her pastor was POA and out of town). In both cases those were two of the angriest patients I ever saw. The first had her ET tube removed once the doctor saw her paperwork and confirmed with her that she was indeed a DNR; she was pretty much in her right mind and was mad as hell. She lingered for a few days and expired peacefully on the med-surg floor. The other was kept in the ICU on the vent until her doc returned from vacation, which IMO was criminal. I had her the day he returned and she glared at everyone, especially the RT when he came in--such venomous looks! I sang to her when I was in her room, mostly hymns and spirituals, and she softened up a little for me. When the pastor finally came in that afternoon, he asked her if she really wanted to be removed from the vent and if she understood that being removed meant she would not be able to breathe on her own for long and would die. She nodded vigorously. I called the attending, he came in and wrote the orders and the RT came to remove her---and got one more nasty look for his pains, until she realized what he was doing. Once the ET was out, she relaxed for the first time all day. I sang "Steal Away" and she smiled at me and closed her eyes. She died quietly about a half hour later. When my 91 year old home health patient had what I was almost certain was an MI and refused to go to the hospital, I called her doctor and explained the situation. He wanted her to go to the ER, but she continued to refuse. I explained this to him and he said, "But she'll die!" and I said, "Dr. F, she's 91 years old, and she's tired. I don't think we can *make* her do anything." He was very quiet for a minute and then gave me some orders that made pretty good sense, comfort care, etc. The patient stayed at home and a couple of months later had "the big one" and died in her own bed where she wanted to. I found out a few weeks after the phone call that the doctor was on the list for a liver transplant (Hep C) and so was grappling with his own mortality. I had a number of his terminal patients after that and he was just great with them. When it was my 91 year old dad with pneumonia, we hospitalized him and did antibiotics and everything, but he was "Do Not Intubate". He was extremely ill but recovered and went home. However, he was very weak and not able to get around. He had dementia, and was so stubborn he wouldn't use a walker, so of course he fell and the home care aide couldn't get him up. It was at that point that we had him put back in the hospital so he could be evaluated for rehab in a SNF. He was placed, but soon refused to cooperate with rehab so we stopped it and let nature take its course and he died of CHF several weeks later. We had made him a DNR before he was place. Lessons were learned! My brother the MD said that in retrospect he didn't think we should have hospitalized him the first time. My other brother disagreed but said we probably should have sent him straight to the SNF. Lessons learned...we kept mom at home with a full-time caregiver until her death 3 years later. She was a DNR, and was on hospice for the final 6 months of her life, and when she got sick the last time (probably aspiration pneumonia) the doctor prescribed PO abx. She took a couple of doses mashed up in pudding but then refused any more PO, and died quietly in her own bed with her namesake granddaughter beside her and the music of her youth playing softly on the radio. My daughter said she was smiling.
  2. Bat Lady

    Funniest, Weirdest, Most Unusual Baby Names

    One of my college professors was William A. Williams, and a popular TV announcer where I lived for many years was Bill (one assumes also William) Williams. When I worked neonatal, we had a baby girl come through named Chivas Aspen. Someone joked that perhaps those were the circumstances of her conception. Then there were the two daughters born to the same couple about 18 months apart, Camry Pearl and Castle Estelle.
  3. One thing you will probably *not* get as a new nurse is a home health job. Home health requires knowledge of a variety of conditions and really strong assessment skills. When I was doing home health there was practically a beaten track between critical care/stepdown and home health, because critical care nurses would get stressed out and need a break, or want some part time or weekend work or whatever, and so they went back and forth.
  4. Bat Lady

    Funniest, Weirdest, Most Unusual Baby Names

    When I worked in the nursery we had a girl baby who was given the name "Chivas Aspen". It provoked many snickers as to how/where she might have been conceived. We also had sisters born about 8 months apart who were called "Castle" and "Camry". So then I went off elsewhere and encountered folks named "Cheerful" (F), "Tiny" (M, about 6 ft. tall and 250 lbs.), "Dimple"(F), "Gidget" (F, 30-ish), and "Lady". Growing up, I knew a county judge whose name, Lord help us, and this IS the truth (you can look it up, it was Milwaukee, WI), was Christ T. Seraphim. Christ was pronounced with a short "i" though.
  5. Bat Lady

    Funniest, Weirdest, Most Unusual Baby Names

    "Melina" (pronounced the same) is a Greek name that means "honey". If you are old enough you might remember the actress Melina Mercouri. (And incidentally, "Melissa" means "honeybee".)
  6. Bat Lady

    A rough nursing shift...

    When you come in, have a code in the first 30 minutes and spend the night trying to keep that patient (who was brought in essentially dead) alive, and then have a code on a DIFFERENT patient at the end of the shift! As my brother the doctor always says, "Jesus is gonna come at shift change, and with our luck we'll be tied up in a code somewhere."
  7. Those who are studying for a degree in Healthcare Administration should be REQUIRED, as part of their degree, to spend a year doing clinicals under the guidance of CNAs and nurses. Only then will they fully understand what it is that we do. They would, in my vision, have to shadow and, as we did as students, actually work alongside the nurses, the CNAs, the dietary staff, the radiology techs, and even housekeeping, to see what makes the hospital run. THEN they will know that it takes people to make it go, and that the hospital can't make a profit without us.
  8. Bat Lady

    An open letter to the #NursesUnite movement

    ^^^^^^^THIS^^^^^^^^^^^^
  9. Bat Lady

    An open letter to the #NursesUnite movement

    This is lovely, until you spend your entire working life in right-to-work (or as my late husband was fond of calling it, "right-to-slave") states. When I applied for my first job, I was told flat out that there were no unions, and that if I was caught trying to organize or in any way promote union activity, I would be fired (this was in the 1980s). Union organizing or activity was similarly frowned on, though not so explicitly forbidden, at all other hospitals and agencies where I worked during my career. When I worked as a traveler, I once had an assignment at a hospital in a state where unions were a routine thing. This hospital had a nurses' union, and I could see where it definitely benefited the staff. Of course it did nothing for us travelers.
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