I have been a registered nurse for twenty-seven years. Ten of the last years I’ve been disabled with Lupus and Fibromyalgia. In the last eighteen months, I’ve been hospitalized three times, twice in ICU on a ventilator, and once on PCU with pneumonia. I’ve learned a lot about nursing from being a patient. I’m sad to say that the things that bothered me most are things I did as an R.N.
First thing to remember: comatose patients can hear you. It may be bits and pieces, but we do hear things. Real things seep into our subconscious and mix with nightmarish hallucinations. I remember from my second time I was found unconscious at home, that two people were talking over me saying, “It’s bad enough she comes in with a 106-degree temperature, but she has her period too.” That was a bit disconcerting, and embarrassing as well.
Then there’s being intubated in general. The rule is: anyone who has a tube down their throat will probably try to pull it out. I’m all for restraints. I know that hospitals are frowning upon restraints, but believe me, I worked in critical care almost all my years as a nurse, and we always restrained their hands. And some of them still managed to pull their breathing tubes out. I did. My best friend, Marie, who’s been an RN for twenty-nine years, and my husband, who’s been a Respiratory Therapist for twenty years, were both visiting me and untied my restraints. And guess what? I tried to extubate myself. It’s a natural reflex. It doesn’t feel right in your mouth. And the spongy things most hospital use to moisten a patient’s mouth? Someone really needs to invent something new. The feel horrible in your mouth. They’re better than the old lemon-glycerin swabs we used to use, but not much.
Also, most people can’t write notes while on the ventilator, unless they are totally awake and alert. Did you see the episode of “Grey’s Anatomy” when George wrote “007” on Meredith’s hand? She tried to get him to write down what he wanted but he couldn’t. Neither could I. I kept writing “IC” and the nurses thought I wanted ice. But what I wanted to tell them (and I did when I was extubated) was that I had IC—Interstitial Cystitis and the Foley catheter they had in my bladder was giving me excruciating bladder spasms. But I forgave them for that one; I would have thought “ice” too.
It’s also important to tell a patient where he is. Not just “in the hospital”. Tell them what hospital in what town. I woke up from my last coma and peered out the window and thought I was somewhere in Philadelphia. I was wondering where my cell phone was so that I could call my husband to come rescue me. Finally, when my pulmonologist came to see me, I asked him where I was. It was a great relief to know I was in our local hospital, just five minutes from my home. Not one nurse ever told me where I was, or how I got there, or what I was there for. I got all of that from my doctor and my husband. But it would have been nice to hear it when I first woke up. The last thing I remembered was going to sleep in my bed one night. The rest was a mystery that I had to wait to hear the ending.
And nurses, be your patient’s advocate. Look at their medications they are on at home. I was on OxyContin at home, and during my first coma, it was not replaced with any other narcotic. I went through a vicious withdrawal. My pain specialist thought it was great that I got off OxyContin while in a coma, instead of going through rehab. I would have taken rehab over the incredibly frightening hallucinations I had while comatose. The first couple were more amusing than frightening. We were renting a storefront room, which was all purple, from an old boyfriend. In the second, Leonard and Sheldon from “The Big Bang Theory” came to visit me while I had lunch with my husband on a patio outside a mental health office that was decorated in hair. All hair. The walls, the furniture, the people’s clothes. But the calm hallucinations were followed by frightening ones, of being tied down while my son was taken from me. Tied to a recliner in a room full of aquariums filled with fish. And when I woke up, I was in pain and there were no pain medications ordered for me. I am a chronic pain patient, and without pain medicine, I can’t sleep or do much of anything. I didn’t sleep for four days. I maintained a good sense of humor and was nice to all who cared for me, but it would have been nice if one of the nurses showed the doctors my medication list. The hospital didn’t carry the medication I take for IC, and I finally got it when I was extubated and my husband brought in my prescription from home.
And here is the most annoying thing that nurses tend to do and I did too: talk over the patient while giving patient care, such as a bath, or changing the bed. You become a piece of meat, a lump in the middle of the bed that is a nuisance. I heard about boyfriends, husbands, weekend plans, lousy nurse managers, lousy assignments, being sick. No one asked me how I was doing. I can honestly say that I did talk to patients in the ICU when we bathed or changed their beds. I told them when we were going to roll them to the other side that we were almost done, that I’d get them a warm blanket when we were done. But I did talk over the patient—about my upcoming marriage, then my pregnancy, about the skuttlebutt going around the unit, etc. If I was working now, I wouldn’t do it. I’d focus on the patient. Just remember; if that patient wasn’t there, you wouldn’t have a job. And in this day and age, a job, even in nursing, is hard to come by. So appreciate your patients. They put food on your table and a roof over your head.