Pneumonia

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Very confused patient on being told she has pneumonia:

“What! I have pneumonia? That’s the worst kind! I must have aspirated! Always happens to the women in our family. They go the hospital, they come out with pneumonia. Most women leave the hospital with a baby, ours leave with pneumonia.”

At this we couldn’t help but laugh and laugh. Unfortunately this lady was talking gibberish all.night.long. and we were going nearly stark raving mad from not being able to escape the incessant perseverating. But at this comment, we had to laugh.

Falls in the Night

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THUMP!

That’s an awful sound to hear at 10:30 pm. When you are working in the step-down unit and your patient is just steps away from you, hearing that they’ve fallen out of bed is a lousy feeling. Rushing over to discover that not only have they fallen out of bed, but that they hit their head and a largish puddle of blood is quickly forming on the ground is even worse! And then having to call the family to let them know what happened is stinkiest of all.

It’s a fact of hospital life that patients do fall and it can’t always be prevented. Sometimes patients are a known “falls risk” and sometimes it’s unexpected, like in this case. On the one hand it was good that he was getting well enough to start seeking independence, but unfortunately his thinking was not coherent enough to realize his limitations! Thankfully all ended well – we assisted him back to bed via the overhead electronic lift and sling, the bleeding stopped quite quickly and he suffered no adverse effects.

1887 Nursing Job Description

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How intriguing to take a look back at the history of the nursing profession.This list illuminates the day-to-day tasks and regulations pertaining to the life of a nurse in 1887.
In addition to caring for your 50 patients, each bedside nurse will follow these regulations:

1. Daily sweep and mop the floors of your ward, dust the patient’s furniture and window sills.

2. Maintain an even temperature in your ward by bringing in a scuttle of coal for the day’s business.

3. Light is important to observe the patient’s condition. Therefore, each day fill kerosene lamps, clean chimneys and trim wicks.

4. The nurse’s notes are important in aiding your physician’s work. Make your pens carefully; you may whittle nibs to your individual taste.

5. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m., except on the Sabbath, on which day she will be off from 12 noon to 2 p.m.

6. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes, or two evenings a week if you go regularly to church.

7. Each nurse should lay aside from each payday a goodly sum of her earnings for her benefits during her declining years, so that she will not become a burden. For example, if you earn $30 a month, you should set aside $15.

8. Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop or frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity.

9. The nurse who performs her labors [and] serves her patients and doctors faithfully and without fault for a period of five years will be given an increase by the hospital administration of five cents per day.

*Wow! What surprised you most about this list?

In the not-so-still of night

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I step out of our Level II Step Down Unit to see what’s going on. Muffled yelling and banging could be heard from down the hall. It’s just after 11 pm. I’m greeted by a cloud of dust literally billowing from the next room over. What in the world was going on? Further investigation revealed the 4-bed room so filled with dust, that not only could we not see, but breathing was difficult too. Time to don our N95 masks and start a scrambled evacuation of the patients! Waving the air desperately in front of me in order to clear it and enable me to see what was going on. Unlock the brakes, disconnect O2 tubing, hurry, hurry – push, pull to a thankfully empty room on the other side of the hallway. Quick, run back for the oxygen set up. Everyone ok? One patient slept through the entire fiasco. The other was a bed-ridden, trached patient, lying there covered in the dust (baking soda!), but was A-ok thanks to our prompt evacuation. Fire alarm going off: Code Red! Then, Code White! (combative patient). Fire men arrive. Thankfully the mess was contained to the one room and hallway area just outside of it.

Who knew that a blood transfusion could turn an elderly, cute-as-a-button patient into a super-confused, combative man on a mission? He had grabbed a fire extinguisher from the hallway and then hid out on his window sill. When confronted, he proceeded to hose down the whole room! (It was filled with baking soda). In his confusion, I can only imagine what kind of horrors he was reliving, perhaps of being in the war as a young lad?

That sure made for an exciting, eventful night shift!