Tuesday, 1 July 2008

Summer in the City

Hot damn. Looking out at the rain now, I find it hard to believe where my sun burn came from today.

I'm tired. The long day took more out of me than I thought. I spent the day reading, playing games and having fun. Whilst fully hydrated, too. Good news.

Right, my expanded review of yesterday.

The New Class

As mentioned, my bay is now inhabited by men with varied, including mental health, non-cardiac disorders. Parkinson's, possible Dementia, a sub-dural haematoma. Allsorts of stuff, and it was quite a shock to be plunged back into. Not that I am under any illusion that I will always get (or want) 'easy' (and by that I mean self-caring, independent and jolly) patients, but it was a seachange. I coped, though.

Teary Oedema

One of the patients in my team (but not in my bay, recently) is a lovely old dear. Bit hard of hearing, suffering from Congestive Cardiac Failure. This means her heart cannot pump effectively, which means fluid can build up around various parts of her body. In her case, she has fluid (oedema) around her lungs, and in the tissue around her legs. This makes it hard for her to walk, and keeps her very short of breath. Because of these things, she buzzes the nursing staff and uses a commode next to her bed.

Generally, she wants to stay independent and I'm happy to encourage that. However, yesterday she was attached to a pair of drips. On transfering on her own she sat on one, and couldn't reach her buzzer. I found her in a right state, crying: so I paniced. Shit - had she ripped her canulla out? Was she in intense amounts of pain?

No. But more importantly she was upset. She told me she felt 'like a fool' for doing it, which I immediately chided her for. But I was quick to comfort her, just talking and being there for her. Chiding was not the order of the day, but comforting worked a lot better. I sat on the floor, chatting with her for a while before going to find her nurse. I think it turned out alright, in the end.


Morbid title, non? One of my newer patients came to us on the palliative pathway, which was something new to deal with. It was something I blagged it, really, just chatting with him and providing cares as he needed them. I chatted man stuff, as much as possible, about women and work and stuff. His discharge was due on Tuesday, going home to spend time with his family and - frankly - die.

On Monday, once he'd pulled me aside and asked, I went down to CT with him twice. These scans seemed completely unnecessary, since he was no longer for active treatment, to me, and seeing him stuck on a trolley in the middle of an NHS corridor was quite sad. Two hours later we were back on ward. He was sitting up in bed, surrounded by his family, smiling. And suddenly I thought: that's it. Morbid or not, that's the way he wanted to die. And it's a good one, you ask me.

Edit: The man from the above section used the old line that, when asked if he had any allergies he'd joke: "Women." The old ones are the best ones. I was talking to him at length about it and, with a tear in his eye, he told me: "Not the wife. She's the only one I'm not allergic to." God, it made me feel better about birds, who have not been my favourite demographic in recent days. The female population may be generally silly, but it's good to know there are exceptions. I'd forgotten about them for a little while, but it was a sweet reminder from a sweet gentleman.

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