I glance at my assigned patients’ charts before report. I see one has an area for documentation of restraints. Damnit. Maybe it’s old documentation and the restraints have been discontinued.
Day RN: “Hey! I have a golden patient for ya tonight.”
Me: “Is he still in restraints?”
Day RN: “Oh yea…”
Me: “Mother f*cker.”
Restraints are annoying for many reasons. There’s an obscene amount of documentation required (visual checks every hour, physical assessment every 2 hours, reassess the need for restraints every 4 hours, etc.) More importantly (and most obviously), the real issue is that you are going to have to care for someone who was put in restraints for a reason. Damnit.
The night begins. His room smells like smoke, “Um, you haven’t smoked in here have you?” I ask his wife. She looks confused, stumbling for words, “Oh well… I mean, no, I probably still smell like it from downstairs.” She must think I was born yesterday. He won’t take his meds. He spits them out. He’s aggravated. He wiggles out his rectal tube at 2AM. He tries to pull his foley.
I have him again the second night I work. Still in restraints. At midnight he begins to yell, biting off his restraints, tiny pieces of the material are all over his bed. I assess him, is his foley ok? are the restraints too tight? He tries to hit me. I call the doctor. Bless that MD, he gives me Haldol; the patient is out the rest of the evening.
I peek my head in to check on him at 2AM. The wife sternly calls to me:
Her: “You! Come here.”
Me: *I wish I hadn’t used all that Haldol on your husband.* I walk in.
Her: “Why did you tell the doctor he tried to hit you? I told you to stay away but you didn’t and then you blame him. You need to listen to me, I know him better, I know more than any of you, I only come here because you have medications…”
Me: *Ok. Be professional* “I’m sorry you’re frustrated. For safety reasons, since he’s in restraints, I have to assess your husband closely to ensure nothing physical is causing the agitation.”
Her: “Don’t try to explain it, don’t talk to me about it. We all have to answer to the man upstairs.”
Me: *silent… is she talking about the doctor? Or…. can’t be God, can it? That would be too idiotic.*
Her: “I’m here to help him and the nurses. Want everyone to be safe.”
Me: *Psh, yea right lady; he’s an alcoholic for a reason.* “That’s good to hear because that’s my goal too. Perhaps his aggression was intensified due to fatigue?”
Me: “He hasn’t been sleeping well. Maybe he got so agitated due to fatigue.”
Her: “What’s “duetafatiq?”
Me: *F*ck. This. Job.*
Her: “I don’t know what “duetafatiq” is but you just need to take it up with Him. We all gotta answer to Him.”
She starts texting mid sentence, never looking up, without any word of thanks or goodbye. I leave the room silent, shaking from disbelief, disbelief that these are the people using the earth’s resources, the people I’m spending my time and energy “helping.” Nothing. Absolutely nothing (except lots more money) would make that kind of interchange worth it to me. Not all the special moments with all the good patients in the world could make up for that example of humanity’s idiocy. Some people can look past it and I envy them. But I can never forget the moments that shine with pathetic examples of human existence; they weigh too heavily on me.
Life is too short. Expending my time and energy on aggressive dying people who try to hit me and moronic family members who don’t know what the word FATIGUE means (WTF, PEOPLE!)… I can’t do this. I’m getting out.