The Day Shift

As a few of you might know, my schedule has changed a bit.  I'm now a day-shifter!  It's really exciting because now I don't have to work my life around getting caught up on sleep.  It's the weirdest thing.  I was on night shift for 3 years!  I said when I first took my job in Montana, I'll only do this night shift thing for a year, and then move up the ladder and go to days.  Well, I never did, mostly due to fear.  But now I did it and things are going pretty well.

Day shift is different than night, weird huh?  Patients eat meals during the day.  Their family, and friends, and any old person that's in the hospital come to visit them.  There are people everywhere.  Therapies are in and out of patient rooms, updating me about their progress.  And oh, the doctors.  They are around too, but that doesn't mean they are any nicer on the phones.  They just aren't half asleep when I call......usually.

The only part that makes me sad is all the co-workers I don't get to hang out with anymore.  Typically, night-shifters are a little more laid back and there is more time at night to chat with co-workers.  I miss that.  I miss the people I worked with, and they call me "traitor."  I know it's a compliment that they wish I hadn't switched, but girls gotta do what a girls gotta do.  The day shift seems to have received me well, but I'm still working my way in with some of those cranky nurses we all know exist.  

So here's a story for you:  Last week our charge nurse was sick.  So my boss thought, "Hey, Kelsy used to charge on nights, she could figure it out on days.  Let's throw her in."  And he did.  I was charge nurse on our busiest day of the week.  We had 15 discharges that day!!!  That was a new record.  We kicked over half of our patients out that day.  And then you have a charge nurse that has never done a discharge before.  We don't do many of those on night shift, if any!  But I figured it out, got my feet under me, and tried to keep a smile on my face.  I even received an award for being so flexible and keeping order to an otherwise hellish day.  So there you go, I pin a rose to my nose.  :)

A big long update, with numbers

 I know I've been AWOL.  Sorry.  Maybe nobody reads this anymore, so in that case I shouldn't feel bad at all.  But if any of you still check out my blog, here I am.  I've been busy.  My schedule at work got all flip-flopped, then I went on vacation for two weeks, and I kinda have a new friend that is a boy, so I've been crazy.  I'll just update you with a few things that make me happy and we'll leave it at that.

1. A few weeks ago I took a little road trip over to see my sister.  It was a pretty short visit, but just to spend a little time with that little niece of mine makes it always worth it.  She grows more and more every time I see her.  Oh and she's talking so much!   Kristen and I hung out, doing what sisters do.  

2. On my last night of work before I left for vacation I had a really sweet patient, that was rough on the outside, but super soft on the inside.  She played cranky with me, but I threw it back at her, as I do with certain patients that I know won't be offended.  She liked it.  We go along great.  It happened to be her birthday the night she came in to see me.  We talked about what she'd be doing if she were home.  She said she'd be drinking wine.  I decided I really liked her them.  We talked about this type of wine she liked, and she urged me to try it.  I said I would.  The next night I came in and and low and behold, she had her family bring in the wine she liked.  All wrapped in a brown paper bag, so I could sneak it out without looking suspicious.  It was the sweetest thing a patient has ever done for me.  We're technically not supposed to take gifts from patients, but in that case had I not taken it she would have been offended.  Now I wouldn't want to offend a sweet old lady!  So I took it.  I hugged her and thanked her.  It just goes to show why you never judge a book by it's cover.  

3. The beginning of my vacation started in Salt Lake City.  I got a one-way ticket to see my friend, Kaleena from high school.  She has an 8 month-old that is as sweet as can be.  We tooled around and she showed me her life in Utah.  We went to a tulip garden that was absolutely beautiful.  It was nice to catch up with an old friend.

4. For my vacation I'd been planning a trip to Utah to go to Zion National Park with a few friends.  We camped, for 4 nights, and then checked out Bryce Canyon on our way out.  It was 5 days filled with hiking, eating, goofing off, and hiking some more.  I was so sore when we got home.  We drove the trusty "black bullet" and had safe travels.  By the end of the trip, with no showers, we were all a smelly bunch.  We stopped in Salt Lake City and showered, then drove through the night to get everyone back to work on time.  Oh the things you do when you're young....
Here's a few pics:

Top of Observation Point: Elevation Change: 2400ft...whew!!

Kolob Canyon

(left)The top of Angels Landing: A very popular hike that has chains on the way up to keep you from falling off the side of a huge cliff.  Yeah, that was not quite my idea of safety.

(right)Hiking the Narrows in my wet suit!!

Quick stop at Bryce Canyon

Kolab Canyon

5. All in all, I've been having a lot of fun lately.  But for more news: I'm on the day shift now!!!  I finally got switched to work a day-shift schedule.  So far, it's been a real adjustment because days are very busy, and now I have a lot more things to keep track of.  But it is totally worth the change!!

Taking the time

Usually in my night to night work, it's rare that I have the time to do something that goes above and beyond.  I try to make an extra effort as I'm medicating, or changing a dressing, or taking someone to the bathroom.  I try to engage, have a little chat about something other than being in the hospital.  Or just take the time to encourage a patient.  In this day and age, it seems, the big wigs just continue to add things to my list of to-do.  Say this.  Address that.  Make sure you say "side effect."  
But occasionally, that one moment I have for a patient can make all the difference for me, and hopefully for them.  On this occasion I had a patient back in our lock-down room.  He had been a bit ornery and was frequently having visits from security.  He wasn't sleeping.  I kept trying to make him comfortable. Find something good on TV.   With all the time I was spending in his room, I started to notice he was looking a little worse for wear.  We hadn't been able to shower him in a few days, and his whiskers were definitely in need of a trim.  So I got the old razor, shaving cream, and set to work.
I think I caused him more pain than I wanted, but he was a good sport.  Let me just tell you, Bic single blade razors can only do so much.  It pulled quite a bit, and he would say, "Oh, easy."  To which I would apologize, but keep going.  It needed to get done.  He lay back, rested his eyes.  This was the most calm I'd seem him since he'd been admitted.  Trying to get him to move his lips and even out some of his wrinkles was a chore, and quite entertaining.  "Move your mouth like this."  "No, like this, open your mouth with your lips over your teeth."  I did my best.
It was such a good feeling to  do something extra for him.  He needed it.  I needed it.  I decided that feeling was worth being late with things sometimes, just to take that extra time.  It's worth it.

Anesthesia Flip

It happens quite frequently that after a patient returns from surgery they come out a personality from a different life.  You could have a patient that is rude, demanding, and short before surgery.  After recovering and taking an hour or so in post-anesthesia, they could come back the nicest patient of your life.  It could be the fentynl talking, but still it's nice.
Or sometimes you have the opposite effect.  This patient was a nice guy.  Having some issues, so he needed to go to surgery.  Not immanently, but soon, basically to make him feel better.  Prior to surgery, he was making jokes, introducing me to his wife, very supportive family, telling me about his work.  Really easy to deal with.  So he goes to surgery.  Everything goes fine.  Post-anesthesia calls to give report on surgery, and how he is recovering.  Different story.
The nurse says this, "Well, he's not doing the greatest.  We have him in restraints.  He was spitting at us earlier, crawling off the gurney, and pulling out his IV.  He's quite confused.  Not oriented to time and place at all.  I gave him versed, ativan, and dilaudid.  Nothings working."
Great.  Sounds just peachy.  I tell the nurse, "Well, send him.  It can't get much worse."  I call my supervisor, let her know I may need to 1:1 patient sitter to keep this guy in bed.
He returns to the floor.  And from there my night got interesting.  He frequently was kicking me out of his room that night, saying things like, "Get out of my room.  I'll call the police."  Of course my priority was to keep him safe.  He ended up doing fine through the night.  The dilaudid finally caught up with him and he settled down.
The next night I had said patient again.  He was doing much better.  At this point he had cleared all the crazy medications anesthesia threw at him and was much more himself.  He was even clear enough to apologize to me for how he had treated me the night before.   He was really embarrassed. He apologized profusely.  To which my only response could be, "Really, don't worry about it.  This happens all the time.  You were not yourself and I understand that is not you.  Anesthesia can do that to you."
So a word of advice:  When given the opportunity to have a spinal anesthesia, take it.  A general anesthesia will mess you up.

Embrace Goodness.

Obviously I've been in a little bit of a dry spell.  Just not really sure what to write about.  Of course I always have a million and one things I could write, but a lot of it would probably be too much and maybe a little boring.  The mind of this girl can get a little crazy sometimes.
But I want to let you in on a few thoughts I've had recently.  Nothing to do with healthcare, my job, or violent patients.
So here goes:  You know when you have something really good standing in front of you.  Its yours.  There is nothing to worry about.  The only thing that gets in the way is you.  Your own issues.  Your own insecurities.  An example would be this: A donut.  I love donuts.  So good.  Fluffy, sweet, and oh the maple frosting (if thats your fancy).  So you order the donut, it's sitting in front of you and your about ready to dig in.  Those thoughts float through and say, "Are you sure you wanna eat that?"  "This is gonna go straight to me hips."  "Hey that lady is eying my donut, I better shove it in my mouth before she steals it."  Okay, that last one doesn't usually happen, unless I'm eating a donut with my dad, but you get the idea.  It's our own choice to ruin that sweet moment before you take that first bite of the donut.  
It's just like that when you have something really cool going on in your life.  Maybe it's a new pregnancy.  Maybe a new job.  Maybe a person, place or thing.  It could even be the littlest thing.  This is my own issue, but I am constantly thinking about when it will be taken away from me.  When will it fizzle.  When will I get fired.  When will something happen and I have to move.  When will I lose it.  Maybe I'm just trying to be prepared and ready myself for whatever may happen, but in the process it takes the joy out of the process.  I ask myself, why do I do that?  Yes, I have past examples when I've been let down and extremely frustrated, so it's natural that I would tend toward these thoughts, but why am I focusing on the past?  
Have you had this experience?  Something really great is going on in your life.  You're super excited about it, but there is always that little thought in the back of your head, preparing you for the downfall.  I guess if thats you, because it's me, I want to say this: 
Let it go.  I don't want those thoughts invading the goodness that God is showing to me.  If the downfall comes, I know I have a great God that will pull me up by my bootstraps again.  Let those doubtful thoughts be fleeting.  Embrace the goodness in your life now.  

Happy last day of the love month!  Tomorrow is March!!

Just another day at the office...

Things have been slowing down at work, kinda.  In other words, I'm just getting used to it.  My unit has gone through several changes lately and co-workers are not pleased.  I've been trying really hard to have a positive attitude and encourage, but sometimes that's hard.   Our heads are still above water though....thanks to security.
Last night was a busy night.  Hospital is jam-packed.  Literally rearranged patients so we can fit them into every nook and cranny of the building.  We get a male patient up from the ER that I'm familiar with. Basically, he was a police hold for safety.  The only thing we had to do for the night was keep him safe and not let him leave.  Keep in mind, he had a tendency to get a little frisky, as in throwing punches and kicking people down.  Luckily for us he was in a great mood.  Being very compliant and was actually quite cute.
Of course at shift change at 0700 I eat my words every time.  Seems like every time I'm just ready to clock out, something goes down.  So, I went in to check on said patient.  He's putting clothes on, yelling at his "safety officer," which is usually a pointless term.  Unfortunately in this situation, we need to keep the patient in the room, and sometimes we need to lock the patient in the room(we have orders for this, so it's okay) to keep safe and others safe.  As I was trying to get the door closed and locked with patient inside and safe, he burst through the door and got into the hallway.  I get him to sit down on a chair and take a few deep breathes.  As I'm trying to diffuse the situation, said patient gets mad at me and starts swatting at me and I think I saw fire in his eyes.  To which I promptly step back and realize, 'Hey, I'm in a corner.'  I was literally screaming in my head, "I'm in a corner.  Oh crap."  Luckily I maneuvered out of the corner to get up to the nurses station to call security and alert them of the situation.  In that time the patient comes around the corner with several staff following, and heads down the hallway to another unit.  At this point, I have to call a code "violent patient" overhead which is always exciting because every male in the hospital shows up.
Luckily the men showed, and they had to escort poor patient back to room.  All in all, it was a pretty exciting few moments.  And I'm once again so thankful for security.
PS- In other news, my boss told me today that he's heard I've been doing a great job of being charge nurse and that he's very impressed.  Sorry for the lack of blog posts lately. :)

So I was changing this dressing...

The other day at work I was finishing report, when a Nurse practitioner I work with asked me for some help.  He said, "Has the patient in room 'whatever' had that much drainage all night?"  I said, "Well at the beginning of my shift there wasn't a lot, but it was oozing a bit."  He said, "Well, would you mind grabbing me when you go to change it?  I want to see the incision."  Okay, I can do that.
So when the time comes, right at the end of my shift, when I love to stay late to change dressings(insert sarcasm), I grab that NP and tell him I'm going to change the dressing.
We head into the patients room.  This patient was a nice little man, with a little bit of a mental deficit, but super kind and had a great sense of humor.  We got him up on this side so I could take the old dressing off and allow the NP to take a look at the incision.  The NP was being super helpful, which was totally a surprise as he is usually rude and bossy.  I took the dressing down and NP asked me to spread my fingers in a 'peace' sign and push down on either side of the incision to see what kind of oozing I could create.  Super cool, right?
So I push down with my fingers on either side of the patients incision, and right as I do so the patient lets out the longer, funniest FART of my life.  It felt like it lasted a lifetime.  
And then I died.  Laughing.
I was almost doubled over, with my hands still on the patient, laughing.  I know, super unprofessional. I just couldn't help it.  My patient's only response was "Oh sorry, I farted.  Did I poop?"  Nope.
NP's only response was, "I love when that happens first thing in the morning."
I died.  Literally.  I walked out to my car from work that shift and just died.  Of laughter.
It was worth staying late for.

And Then it Got Violent

This weekend was interesting.  Or you could just call it crazy.  Friday night we admitted 5 patients before midnight, which is unheard of, then Saturday we admitted 7 patients by midnight, so I guess it's just becoming the norm.
Friday we had a patient that decided to leave.  Patient just got up and opened the fire escape and started down the stairs outside(note: we can't always keep eyes on all our patients, sometimes they're sneaky).  Of course the fire alarm sounded which sent everyone running.  We called a code over the intercom system to get some help, but in the meantime it was up to my staff, you know being charge nurse and all (ick), to deal with it.  We got the patient back inside, but then Patient decided to get mad.  Patient started getting a little frisky, throwing things and such.  So we call over the intercom system another code to get our security guards.  Super dramatic stuff, I know. So of course a couple of big meatheads show up with their security gloves and cargo pants on.  This only escalates the situation.
Side-note: The thing with nursing is you don't get to slink away in a corner in this circumstance.  It's my job to take care of the patient, to keep the patient safe and its the security guards who keep me safe, and sometimes the patient too.
So I calmly approach the patient, lightly rest my hand on Patient's shoulder and ask, "What can I do to make you more comfortable?"  This is always my approach to establishing rapport with a patient.  Surprisingly it works.  No punches are thrown in my face, the patient gets back into bed, apologizes, and begs me not to tell Patient's spouse.  Patient wasn't quite operating on all four cylinders there.

Saturday night was much of the same.  Quite busy.  Another patient getting heated and angry, but not quite as powerful and intimidating as afore mentioned patient.  This one was older, but very quick and wanting to escape (a recurring theme in the hospital).  My priority was to keep Patient #2 safe.  That is always a big priority.  Unfortunately, this patient wasn't taking any medications or letting me give any care.  Patient #2 was so aggravated and paranoid that any time I got close, Patient #2 would take a swing at me, almost got me once too.  Again, no slinking away in a corner where it is safe and quiet.  It was time for full throttle.  So I call my security guard friends, again.  They probably just thought I was trying to find excuses to have them around.
I tell them, "Hey I need to medicate this patient to help Patient #2 calm down and keep safe, but Patient #2 won't let me near, so I need you to hold Patient #2 down, gently, so I can do my job."  This is not usually my form of care.  I don't like forcing things on patients, but this patient was completely confused and would not remember me from Adam later.  Patient #2 was too close to the edge of something big and unfortunately my only option was to sedate the patient.  So Meatloaf #1 and Meatloaf #2 come help me.  In the process a few syringes went flying, but all was safe and secure.   We got the patient comfortable, with my supervisor present so everything was "kosher" and I had lots of witnesses to what was going on.  Needless to say..... rough night.
I'm thankful to have a job that keeps me on my toes, even if it is running in to a patients room who is throwing punches, kicking and spitting.  It comes with the territory.  Not everyone is going to be sane.  But I continue to be thankful for every shift that I don't come home with a black eye. :)

Top Ten

1. The holidays are over...and I'm kinda glad.  I get so excited a few weeks before, and I'm all ready for it.  Then suddenly my mood changes and all I can think about is homeless people and other sad things.  I can't help it.  So I carry on with my Christmas traditions.  But usually when it's over, I'm relieved.
2. At work lately, I've been the charge nurse.  This means I'm the boss of my unit's staff for the shift.  I thought I might like the leadership role...turns out I don't really think I do.  I can do it and do it well, I just think I'm more of a follower.  That sounds bad.  I'm a follower within reason.
3. Walked to the public library today and loved it.  Every time I go pick out a book I feel like I'm in heaven.  It's free.  And there's so much to choose from.  Every kind of book imaginable.  Now if I can just sit still for long enough to finish.  I also wore my yak-traks and I didn't fall.
4. I haven't fallen in the snow/rain/ice yet this year.  It's a new breakthrough.  I usually biff it by Thanksgiving.  Scratch that.  I fell on the ski hill a few days ago. That doesn't count.  Stay tuned...I will probably fall tomorrow.
5. I made this thing called "Chicken Taco Pasta."  It was good.  Here's the recipe.

6. Recently there have been a lot of really ill people in the hospital.  Weird, huh?  Its been really depressing.  People dying that should be dying.  People losing limbs that should lose limbs.  Nice people getting cancer diagnosis.  I've come the conclusion that if I want to live longer I need to be meaner.  I'm reminded daily of fragile life and that it is to be respected.

7. My christmas tree is shedding very few pine needles.  How late do you think I could leave it up?  I like it.  Is it weird if I leave it up until Easter?

8. I have fleece sheets on my bed.  Amazing.  Need I say more?

9.

 

10. Happy New Year.  I'm back on my blog.

Did I eat lunch?

So my patients blood pressure is 70/40 and she's screaming in pain.  Welcome to work.  I pop a second IV in her get ready to start her blood.  We need some volume resuscitation people.  She lost a lot of blood in OR and the recovery room thought she'd be a good candidate to put back on the floor with us unintelligent "floor nurses."  I'll show them.
I get the blood going.  Pushing in fluids wide open in my other IV.  Oh guess what?  Her body decides to react to the blood.  Stop the blood. Push more fluids.  Call doc.  Verbal throwing up into the phone with doc, telling of all things gone wrong, but with class, I might add.  We order labs, more fluids, and no more pain meds for screaming in pain patient.  Oh this will be fun.
Take a deep breath.  Drink a little water myself, before someone has to pick my crumpled body off the floor.  Take another blood pressure.  No change.  Take a deep breath.  This patient is handling her low blood pressure quite well, amidst the cries of pain.  This IV benedryl will help.  She'll just go to sleep.  It's for the blood reaction, I'm not just pushing it to make her go to sleep, that is just an added benefit. :)
Three hours later, doc okays me to restart blood based on patients lab levels.  Great.  I have an hour to push as much blood into her as I can.  Blood is only good for 4 hrs before it goes bad per policy.  I get about 100cc in trying to be safe with previous reaction.  Patient does fine.
Start a second unit.  Blood pressure is improving, but not enough for her to get any pain meds.  80's/40's isn't that good.  The pain meds have a tendency to drop blood pressure, thought you might want to know that.  Finish 2nd unit of blood, patient seems to be perking up.  Chat a little with sweet little patient.  Apologize for not letting her get any sleep tonight.  Oh and now we're going to take your drains out and cause you more unrelenting pain.  Pretty sure I'm satan.  Sweet patient probably thought she was in hell.  Cause sweet patient so much pain her blood pressure actually comes up enough to give pain meds.  yes!
Pain meds given.  Patient resting better.  More stable.  Check in on other four patients.  Make sure my student met their needs and prep a couple of patients for surgery.  Pass some meds to other patients.  Oh guess what, it's time to report off to next shift.  Must be morning.
Did I eat lunch?

It's a tug-o-war

You know sometimes when you're unhappy with what's in front of you and you want more, and in that selfish, vain attempt to get more of what you want from something, you only realize it got worse and you want to go back to what you had before.  Hindsight 20/20?  Does that sentence make sense at all?
Well this happens quite frequently in the nursing world.  You have this patient thats being a bit of a nuisance.  They give you a hard time all night.  I need this.  I need that.  You were 3.7 minutes late with my pain pills.  Why won't you let me eat...I'm hungry...who cares if I choke when I swallow...I want to eat.  As a nurse of these kind of patients before, I've become immune to the rudeness, the impatience.  Nothing you can say or do will change how I care for you.  I may have to get a little blunt with you, but only because I'm trying to protect you.  So when you walk in with the next shift coming on and the patient realizes they have Nurse Ratchett for the next 12 hrs, they have a change of heart, let me tell you.
So I had this guy.....you're starting to get used to my stories starting like that, huh?  Okay, the guy...real sick guy.  Looked 20 years older than he was.  Back-woods, you know, like the majority of my patients.  He was not a newby to the hospital experience.  He knew how our schedules work, how our narcotics come out of a locked machine, and where to get food.  Unfortunately, I could not appease any of his many requests because of a doctors order or some other odd reason.  I put some oxygen tubing in his nose to better help him breath and his response was, "(choice word), how am I gonna pick my nose?"  Many responses flew through my mind, but I kept my mouth shut.
Finally the long night was drawing to a close and the sun was coming up.  I stayed kind, encouraging, and tried to meet as many of his needs as I could, even though it never seemed like enough(a common feeling I have during a long 12-hr shift).  The lab was in drawing his blood, and he decided to get all panicky, with a heart rate in the 130's (which isn't bad, but higher than before) he was breathing real hard and to put it bluntly he was freaking out.  I was able to call the doc, get some medication to help him relax and then we sent him off for some tests.  As they were wheeling him away he yelled back at me "Are you back to work tonight?"  No, I said. "Well, who's gonna take care of me?"
It actually broke my heart a little.  After the difficult patient he was all night.  Cursing at me.  Lecturing me on why he should be able to eat.  Demanding pain pills.  Every outward sign would tell you he was not a fan of me and he would prefer a different nurse, yet there he was...asking if I'd come back to take care of him that night.  Aww, I knew he had a soul in there somewhere.

thankful

Yes. Today I am thankful.  I want to be thankful every day.  Every breath I take.  Every step I skip.  Every touch of the tips of my fingers.
I am thankful for the opportunity to be the person I am.  To embrace myself.  To love.  To care.  To show the love of Christ in me.
I'm thankful for my God.  For His grace that flows freely when I don't deserve.  For His mercy in the morning.  For His sacrifice.
I'm thankful for those who share my DNA.  They know me completely.  Their heart is my heart.  They listen.  They offer.  They are.
I'm thankful for my friend who battled cancer this year and came out victorious.  She showed me power in weakness and has faced the struggle with her head held high and her shield at the ready.
I'm thankful for broccoli cheese casserole, which is a Thanksgiving staple at home.  Though I may not be celebrating with my immediate family, that casserole is the only reminder I will need to know that we are all together by the fact that we will all be eating broccoli cheese casserole today.
I'm thankful for my patient who is heavily addicted to meth.  She taught me the meaning of patience when combing the rat's nest from her hair and that all humans need love, regardless of their choices.  Something I must be reminded of every day.
I'm thankful for friends.  My people.  They have taught me to listen, to offer, and to be open to new things.  I am thankful to have people who will back me up.
I'm thankful for the mountain I climb quite frequently when weather permits.  I love that trail.  I breath in deep with each stride and remind myself that I am alive.  And when I get to the top and sit on that familiar bench looking out on God's beauty, I know I'm where I want to be.
I'm thankful for my Grandparents.  We lost them quite recently and it still hurts to think they'll never see me get married or meet my children, yet I'm so thankful for who they were.  They are why my mother loves intensely and why my father wears his 'cowboy' proud.  Their legacy lives on in all of us.

There are so may things to be thankful for on this day.  May it be something we think of year round. Happy Thanksgiving.

"Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus." -1 Thessalonians 5:16-18

There's this lady

Oh she was hilarious.  I've had funny patients before, but this one was unique.  She came in for routine surgery.  Everything looked great.  She was doing everything we were telling her, doing her exercises, eating well.  She had a mouth on her.  I could tell she was the backwoods type and I kind of like that.
Every time I tried to get out of her room to move on to the next needy patient, I was drawn back in by something she would say, ask, or make a complete random comment about.  ON top of all that, she was boy-crazy like a little school girl.  Mind you, she's in her 70's.  Uh-huh, no joke.
Things like this came out of her mouth:
"Have you seen that physical therapist?  Gawd, he is fine."
"What about that guy that brought up my bedside commode?  Did you see his blue eyes?"
"Oh I gotta watch my show, that Jim guy is on and he is just beautiful."
I made the mistake of asking her what she thought about our surgeons....
"Oh my gawd, that Dr. McSexy(I'm filling this in to protect privacy, and he's not that sexy for the record) he is just gorgeous.  Do you know if he's married?"
Yes, people, that is what I dealt with 3 nights in a row.  Her roommate was forced into being her new best friend and talking boy talk while they healed from surgery.
On my last morning, I walked into her room with the day nurse to take over her care.  I reported off, gave the highs and lows of the shift and gave her an opportunity to add anything she might want noted.  She gladly took that time to talk about herself.  As I started to say goodbye, she held out her arms for a hug.  I walked up, reached across her for an awkward "your in bed hug" and she kissed me right on the neck!  She was so thankful for my care, gracious for all I had done for her.  I appreciated her gratitude very much.  I can say I haven't received too many hugs from patients, but this one goes right to the top.  Best ever.  From the funkiest patient around.

I thought you were my friend

An unfortunate set of circumstances had landed this sweet lady in the hospital.  She had been through the ringer.  You could tell she was nearing the end of her rope, and her husband...he was at the end of his.  She'd had a lousy nurse (yep, they exist) the night before and her day nurse had promised she would have a better night.  Enter: me.
I babied her.  I increased her pain medication so she wouldn't be in so much pain.  I brought her special hot cocoa made with milk.  I made sure her favorite TV show was on.  A student working with me took extra time to spend with her.  She had great service.  I could tell she was much more happy with her care with me than anyone prior.  I had worked my tooshie off to earn that and I wanted her to have a better experience than before.  She deserved it.
She hadn't been sleeping much, even after I gave her a sleep aid.  Around 4am she started getting kooky.  I went in to chat with her and she said, "This call bell has legs."  Oh boy.  Here we go.  She's going to start getting confused on me.  She reoriented easily, but felt that something was wrong.  She made a few calls, quite early morning, to which I spoke to her family members trying to reassure them I was taking good care of her.  I turned off her pain medication and checked her blood sugar, thinking the crankiness was from hypoglycemia.  Nope.
She refused most care, except for me.  The lab tech was frustrated without being able to draw her blood for the am labs.  Instead I drew them off her IV site avoiding another poke for her, which isn't the easiest thing.  As I sat there drawing her blood, she started to cry.  I tried to reassure her and that all would be okay.  She looked up at me with tears in her eyes, "I thought you were my friend."
AND MY HEART BROKE.  I started to tear up with her.  I AM your friend.  I've been trying to do everything I can tonight to help you, comfort you, be with you.  Yet, when the brain starts playing tricks on you, anything can happen.  I did everything I could to bring her back to the situation, to me, to her surgery.  Anything.  I got a little bit back, but not all the way.  She needed time to process all the pain meds she had received in OR and by me.  I second-guessed my turning up her pain medication.  In the end, I know I was treating her pain to the best of my ability, she was just experiencing certain side effects that are quite common.
I did all that I could, but still left that morning feeling as if I let her down.  I WAS her friend.  A fight between reality and narcotics, and reality usually loses.