Tuesday, November 8, 2011

Hands off the catheter, my friend

I had a patient remove his own foley catheter the other day and it was not a pretty site. It's unclear whether said extraction was intentional or not but the result was a positively bloody mess. As you'll see from the diagram below, the catheter is maintained in place in the bladder via an inflated balloon, so just imagine the damage that can be done when that balloon passes through the urethra and out of the penis without FIRST being deflated.

Monday, November 7, 2011

I hear the secrets that you keep...

...when you're delirious and hospitalized.
When asked, "Do you know where you are right now?" of some of my less oriented patients I've heard: "a barn", "a birthday party", "a bus", "a sex lab", and "Serbia" to name a few incorrect responses.

One of the unique aspects of nursing is the intimate moments you sometimes share with your patients. I've heard admissions of hatred of family members, revelations of sexual exploits, and of course there's the usual cleaning of butts, weenies, and va-jay-jays... It's kind of like being the bartender at a pub your patrons never wanted to come to (and often times don't even know they're at).

Thursday, November 3, 2011

Compassion Fatigue

"Compassion fatigue (also known as a secondary traumatic stress disorder) is a condition characterised by a gradual lessening of compassion over time. It is common among trauma victims and individuals that work directly with trauma victims. It was first diagnosed in nurses in the 1950s. Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self doubt."
You hear a lot of talk about compassion fatigue in nursing and I feel like I've seen it. We had a patient from another country who was involved in a serious car accident while on vacation in the US in which a relative of the patient died. The patient was on our unit for several weeks and I would often hear nurses complain about how needy or whiny the patient was. I know I'm new (and I hope this doesn't explain my empathy) but imagine yourself in a hospital in a foreign country where you don't speak the language, you're in a pretty good amount of pain from your injuries, and you've just lost a loved one to boot. I think I'd be pretty needy too.
I wonder why with experience and exposure to patients with acute or chronic pain it seems we become detached from the moment and start to see the patient as a just a complainer. After watching a patient sobbing in pain with tears streaming down their face this week, asking themselves and me why God would do this to a person, it never crossed my mind that this patient was a whiner and I hope it never does.