Wednesday, April 29, 2009

Wrestlemania

I have a good friend who has been bugging me to write this post. It is a funny story, however I think it was much funnier when it happened.

On the day in question, there were about five nursing students doing clinicals on our floor. They were in their last semester and one of the students was assigned to one of my confused patients. I have to say that at the beginning of my shift I was already thankful for this. I got report from the previous shift that this sweet 75+ year old lady, was not so sweet. She lived in nursing home and had become increasing confused. They wanted her admitted for "med adjustments". In the hospital world that means that she was "out of hand" and causing trouble and they needed a break for a few days.




The reporting nurse told me how this lady had not slept all night. She was climbing out of bed, yelling, hitting the staff and pulled out her IV. The night shift was unable to get another IV in her and she had medications that she HAD to have. The doctor didn't want to do a central line because she wasn't going to be there long enough and why risk infection, right?

So when I got to her room to do my first assessment, she was in a vest restraint in bed with a bed alarm on her bed. They had already told me that had used wrist restraints to keep her IV in, but she somehow got out of those. They had also already tried mittens and again, she got out of those.

So, I talked to the Student nurse and explained the situation. She was going to have to stay VERY close to this room all day. We needed her out of restraints for 24 hours so she could be discharged and we had to get an IV in her. . .somehow. The student jumped at this. She needed to do an IV and was so excited.

Later that morning, she and another student came in. That is when the student and I went over the "starting and IV" process. She said she had done one before with her instructor, so she and I were going to do this one. Even after this lady had her medications to help calm her down, she was still pretty alert and just not very nice. So I had one of the students hold her hand and just talk to her. Trying to keep her calm. The other student was going to start the IV while I held that hand in hopes of keeping her from moving it. The lady ALL OF THE SUDDEN turned really sweet. I think she liked having her hand held. The Student who was starting the IV was very confident and ready to go. As soon as that needle hit the arm, the patient turned. She started yelling and trying to move her arm away. She had already been told what we were about to do, but like I said earlier, she was confused and demented. I am sure she didn't remember. As the student kept working, I tried talking to the lady, trying to keep her calm.

The student wasn't able to get the IV, however she was OH SO CLOSE! I grabbed a hold of the butterfly she was using and told her to trade me places. As I was leaning over her to get this IV in, this little 90 pound lady pulled her leg up and put it her foot on my shoulder. At this point I am thinking, "Ok, at least she is not kicking me, I can still do this." I told the students to just leave her legs alone. She was not hurting me and holding her legs would just make her more angry.

Now this is all happening very very fast. I am in the vein, I have a good blood return. All I have to do is flush it and dress it. As I reach for the flush, the patients leg is no longer on my shoulder. Nope, it is now wrapped around my neck!!! I was in a headlock!! All I could do was laugh, but I could still reach her IV and it was still compromised as long as I didn't have the dressing. So, the students continued to hold her hands to keep her from hitting me, and I got that silly IV flushed and dressed with a leg wrapped around my neck.

I know it is hard to believe and you have had to be there probably to see how incredibly funny it was. By the time we left that room, we were all sweating and laughing so hard!!!

The IV stayed good at least through my shift, she got her IV meds and because there were students who could sit with her, she didn't have to have the restraints. I am not one that is big on restraints. I truly believe if there is any other way, then that should be tried first! Restraints most often times, just aggrivate the patient more.

That day, I was pretty impressed with my IV skills. It is not every day you have that big of a challenge. But I was up for it that day.

I was thankful the lady was much more sweet in the afternoon than in the morning! The rest of the day went like clockwork!

Thank God for the nursing students, who learned that day how to become a WWF Nurse!!!

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2 comments:

  1. This is totally hilarious! My favorite senior population to work with has always been those with dementia! They hold a very soft spot in my heart! One question, did the lady win a WWF gold belt?

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  2. Awesome story; I loved it! Wish I could have been a fly on the wall...

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