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Wednesday, March 4, 2009

Shoot yourself daily, but Don't Shoot the RT,

The RN was set up alongside the bed with her IV set, and he had just pulled out another failed attempt. As I entered the room the loquacious patient said, "I think we ought to just shoot the RT!"

"Why would you want to do that," I said.

"Because I'm bored," she said. I looked down at her dry, flaky and pale white feet with those long, yellow nails. This lady had every drug related disease in the book I figured, and I wasn't going to get any closer to her than I had to.

"I have three little kids who would be very, very sad if I wasn't around in the morning."

"Well, I suppose you have a point-- ouch! Can you be a little more gentle!" She was glaring down as the RN repositioned her second attempt. "Why don't you poke under here," she pointed to under her arm pit. "You're probably best off poking me where I haven't been already. I can't reach under here."

The expression of the nurse never changed. I could tell she had had it with this body abuser. She said, "You wouldn't want one under there."

The patient said, "It's not like I havent' poked myself everywhere else."

I gave the patient a breathing treatment and when I was done she said she wanted another. I'm sure if she were home that's exactly what she would have done. But she wasn't short of breath, so I put my neb away and left the room.

Here this lady is admitted so we can fix her and the government can pay for it, only for her to go back home and poke herself some more.

Fortunately all I had to do was one treatment and I was done with this patient.


Anonymous said...

Hi-I found your site while cruising around the internet looking for stuff about COPD.. Anyways your post here got me wondering --- I am caring for mom who was released from hospital last week under Hospice care (we are new to hospice). She has endstage COPD and she is soooo weak, barely eats or drinks now. I started giving her her nebulized Txs a couple days ago even though she is asleep all the time (I was waiting for her to be alert and awake and she still is not, so I felt bad and gave her Txs anyways. -Then when I read where you said something to the effect the pt wanted a neb tx even though she wasn't out of breath.. My mom hasn't been out of breath - do you think I should stop doing the neb at this point.. She was previoiusly doing levalbuterol 4x a day.. Just wondering - any thoughts? - thanks! PS- hospice just always answers - "whatever she wants" - well I don't know what she wants because she doesn't wake up!

Freadom said...

Thanks for the question. I usually like to answer such personal questions in a private post unless I have permission, but since there is not return email and this question is anonymous I
have chosen answered this question in this post here.