Monday, February 1, 2010

captain of this vessel

this happened sometime in november, but it has turned into a favorite nursing story that i am often asked to i thought i should write it down. =)

it was a busy morning. lots of rushing from room to room. orders to be signed off. charting still to be done. family members needing to talk to the nurse. piles of pills to be given. a blood transfusion to be started. vital signs to be checked. it was the sort of morning that gets away from you, and before you know it, it is time to check blood sugars for lunch time. and you wonder where those four and half hours that you've been at work have gone to.

in the midst of this, i was walking a chart up to the nurse's station, when i heard the familiar tone of a bed alarm sounding. and in less time that it takes to tell, i looked up and down the hallway, hoping that there would be someone else to keep this patient safe. the patient's nurse perhaps? or the nursing assistant? but no such luck. one quick glance this way and then that way showed me that i was it. a repeated sentiment from nursing school flashed through my head, "nurses are the patient's last line of defense." i smiled to myself as i quickened my pace toward the noise, accepting the role of the defender.

setting the chart down at the server just outside of the blaring room, i waltzed in quickly, glancing up at the patient's white board as i did so as to ascertain this escaping man's name.
"richard." i stated firmly, immediately getting the 80-year-old's attention. i reached over to hit the button on the side of the bed that would silence the alarm, noting the man's left leg swung over the side railing. i reached over and tried to encourage him to place it back in bed. as soon as my hand left his leg, he swung it back into the position that i found him in.
"richard," i said again, "where are you going? you need to stay in bed."
"i need to pee before i get on the boat!" he emphatically told me.
before i could address his claim about boarding a ship, i glanced down and saw familiar tubing. "richard, i have great news. you have a foley catheter, a tube that goes into your bladder. you don't have to get out of bed to go to the bathroom. you can go ahead and go!"
shock and disbelief flickered across his face as he looked down at his own anatomy and true enough, saw the catheter i spoke of.
as i began to explain, he interrupted me to ask, "are you the captain of this vessel?"
i shook my head. "no, no, i am not. let's get you back in bed."
i lifted his left leg yet again to place it back into the bed, but it would seem richard had other ideas for positioning his body. no sooner had i helped his leg find its way under the covers, would richard swing his leg back over the railing.
richard then began to pull on the tubing come from his body, and i quickly discouraged that, doing my best to explain to the confused man in front of me what was taking place.
with his leg swung over the railing and the apparent desire to remove certain tubing, he asked me yet again, "are you the captain of this vessel?"
i took a deep breath and plunged ahead, feeling that taking command of a ship might be the only thing to gain richard's respect in the situation.
"yes, richard, i am the captain of this vessel. and we need to get you back to bed."
no sooner had i uttered those words than a stubborn leg returned submissively to the mattress and two wrinkled hands suddenly folded onto his chest.
my task of getting him comfortable in bed become simple with my sudden rise to power. but unfortunately, becoming captain did not solve richard's confusion. as i was finishing tucking him in, he asked if i would pretend to be a tree. and not just any tree, a lonely tree. i smiled but declined his request, informing him that his captain had other business to see to.

as i returned to my original duty of delivering a chart to the front desk, i was reminded of one of the reasons i like my job. its true that a nurse may be the last line of defense for a patient, but a nurse also has opportunities that arise unexpectedly during the course of any given day. who knew that today would be my lucky day? the day that i would get to weigh anchor on my very own vessel!