Nurses make the worst patients
Today's ethical dilemma: do I play florid Christmas carols at the bedside of an intubated, retired 61 yr old nurse who had an attempted suicide (note left).
Honestly, she looks 70.
I read through the ED notes, someone described her as "lovely"
I google earthed her address and it's local to me, but her address is blurred out so no photo of her residence is available.
She took 10x oxycontin and 10x diazepam.
We extubated her on only 10 min break of propofol and fentanyl
Her friend arrived shortly after
When I extubated her, approx. 30 mins later she became very angry and said something to the effect of "what does it take?" and "I failed"
she asked this later on of the Dr - Did I not take enough?
Her friend said "yes"
Notes say she had become depressed after her partner died 10 years ago and remained unmedicated.
Heavy smoker and EtOh (which I suppose is one type of management strategy).
Lately she'd been suffering from a lot of back pain, and for the past week had hemoptysis.
I think she thought she had lung cancer or something terrible and didn't want to have treatment.
She had positive blood cultures on admission so they wanted to repeat them right before starting the antibiotics - and she refused. She pulled away her hand, and had a small argument with the RMO. Who then asked me to get haloperidol 5mg. She started to pull at the central line when I informed her I would give her "something to settle" so we could "take bloods"= and that if she allowed us to take them, I wouldn't need to give her anything. She pulled more forcefully on the line (which had a connection and I was holding onto the proximal end so no matter how hard she pulled I had real control over the line - and it popped off (wtf that's not supposed to happen) it's just maintenance fluids so I used that fresh lumen to push haloperidol with zero remorse (I thought I'd feel more) and within 1 min 5mg haloperidol was working a treat.
We started precedex preemptively and she slept for the rest of my shift (until 1400 when I was going to take a new admission due to high risk intubation- and the person coming on is the same new grad I dug out of a hole by doing her meds last week)
Honestly, she looks 70.
I read through the ED notes, someone described her as "lovely"
I google earthed her address and it's local to me, but her address is blurred out so no photo of her residence is available.
She took 10x oxycontin and 10x diazepam.
We extubated her on only 10 min break of propofol and fentanyl
Her friend arrived shortly after
When I extubated her, approx. 30 mins later she became very angry and said something to the effect of "what does it take?" and "I failed"
she asked this later on of the Dr - Did I not take enough?
Her friend said "yes"
Notes say she had become depressed after her partner died 10 years ago and remained unmedicated.
Heavy smoker and EtOh (which I suppose is one type of management strategy).
Lately she'd been suffering from a lot of back pain, and for the past week had hemoptysis.
I think she thought she had lung cancer or something terrible and didn't want to have treatment.
She had positive blood cultures on admission so they wanted to repeat them right before starting the antibiotics - and she refused. She pulled away her hand, and had a small argument with the RMO. Who then asked me to get haloperidol 5mg. She started to pull at the central line when I informed her I would give her "something to settle" so we could "take bloods"= and that if she allowed us to take them, I wouldn't need to give her anything. She pulled more forcefully on the line (which had a connection and I was holding onto the proximal end so no matter how hard she pulled I had real control over the line - and it popped off (wtf that's not supposed to happen) it's just maintenance fluids so I used that fresh lumen to push haloperidol with zero remorse (I thought I'd feel more) and within 1 min 5mg haloperidol was working a treat.
We started precedex preemptively and she slept for the rest of my shift (until 1400 when I was going to take a new admission due to high risk intubation- and the person coming on is the same new grad I dug out of a hole by doing her meds last week)