Thursday, 22 August 2013

Last orifices and confused patients

So my first shift this week started with doing the "last clean up" of a dead body. I knew this patient was going to die - I hadn't become particularly close to her, but I had known her briefly and I just wish I could say she went peacefully. The fact is she was in a huge amount of pain, screaming sometimes, and myself and another HCA agreed that she should have been given more pain relief by the nurses, but the nurse didn't believe she could be in that much pain. Rule number 1: the pain is whatever the patient says it is.

Anyway, I went in to see her, to clean her with another HCA and I thought I'd be freaked. I thought I'd feel a bit sick, or get a bit light headed. I barely flinched and I feel like such a cow for it. Me and An just got on with it, removing cannulas, labelling her, wrapping her up, and covering her with the white sheets. It felt like when I used to put my sister to sleep, I used to say "I'm going to make you into a sausage," and I used to get a few blankets and wrap them all the way around her so she couldn't move her arms and legs, and you could only see her little face as I put her into bed and wished her good night.

Later that day, Matt said to me if I didn't step back he was going to punch my face. Matt is a very confused patient with extreme dementia. His wife had been and gone, and he was very agitated. He was convinced nearby patients had his money. I was the only one there explaining they didn't, and that if he just sat down I would get him a cup of tea, and would he like to put the radio on. He wasn't having any of it. I stood in front of him, and as he wobbled and staggered, he said to me, "Get away from me you dirty cow. You disgusting person. If you don't step back I will whack you in the face. I could hurt you, you know,". I stepped back, he almost dropped to the floor so I grabbed his elbow. As he regained his balance, he went to his neighboring patient Fred. Fred is partially deaf and blind, bed bound and is 90 years old. "Give me moy monay," he screamed at Fred.
I stuck my head out the door, "Can I have some help please!" I shouted, trying my best not to sound like I was about to be murdered.
Fred bunched a fist and waved it in Matt's face. Oh god, I remember thinking, this cannot be happening. Staff Nurse then got in between the 2 of them before the fight broke out.
"Come on Matt," Staff Nurse said. "Let's sit you down," half dragging him half walking him to his bed. He spots the open door to the outside. He makes a run for it.
Staff Nurse and I chase after him. Staff Nurse grabs his arm, "Come on, your wife might be inside," she says. Then, all very quickly, in the confusion and panic of seeing his wife he tries to run back in, but slips and falls on his bottom on the grass. He lies flat and asks me about his money.

Then yesterday, on my 2nd 12 hour shift in 2 days, Staff Nurse Al asks me to watch Matt like a Hawk in full knowledge that he is extremely agitated. Again, his wife had gone. I stand next to him as he sits on his bed, muttering to himself, not really pausing to breathe. I discuss how my electrics are really dodgy in my house (he used to be an electrician) and what could I do about it? He showed no interest, or barely acknowledged that I was speaking. He kept trying to stand up, but being so weak, his legs weren't taking his weight, and so he just kept sitting back down. I distracted him with some coffee and sweets, he had them, but said they were horrible. He then managed to stand up. Sometimes he likes to walk to the reception area and sit with the nurses at the desk, I wonder if this is what he is about to do. He takes a step. We both spot the door to the outside at the same time, closed, but still there. He tries to move me out the way, and falls down again.

Same patient, 2  falls, I am there both times. I feel sick with myself - I don't know how I keep letting this happen.

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