Just Another Night

Oh the things my co-workers can tease me for…I swear…so the newest  joke on me is…I have a thing for old men.  Well at least that’s what my co-workers say after tonight…the night I will almost definitely never forget. 
One of my patients tonight (actually one of my preceptee’s patients) was an adorable 88 year old who was here for cystocele surgery.  She was adorable…as was her husband, who was so attentive he never left her side. 
The night started off busy with two direct admits back to back (with one of them being a surprise because the day nurse forgot to give us report so we had no idea he was coming until he just showed up).  But we made it a point to check on the other patient every hour. 
She had a catheter in place and was on a PCA pump (now really, this was a disaster just waiting to happen but you know that’s the fun in it, I guess). 
We managed to handle the two direct admits pretty well which is actually harder to do then it sounds…and by midnight we were pretty much caught up and in a good spot.  But then trouble began.
The first sign of trouble occurred at about 0200.  When I checked on the patient she was wide awake, her husband sleeping in the recliner next to the bed.  She gave me a really strange look, and if I would have only known what that look meant…I might have just walked right back out of the room without bothering her. 
“Are you having any pain?”  Well of course her response was not what I expected.  “Why the hell would I be in pain!!!!!???”  “Um…because you just…um…had surgery…and I was just um…just wondering”
“No, I’m not in pain…but I need to use the bathroom…right now!!!!”
I did a quick check of the catheter, which appeared to be draining, and I’m sure I sounded pretty confused, “You have a catheter, do you feel like you need to urinate?” 
“Umm…No,…I need to do the other thing.  You know the stinky thing”.  I suggested maybe using a bedpan or even a bedside commode, but the patient was not going to have any of that…”Young lady…I am not too old to go to the bathroom…Now help me get there.” 
I assisted her to the bathroom…regretting that decision from the moment I got her up…she was very unbalanced on her feet, and about took us both to the ground a few times before we made it.  Not the brightest idea I’ve ever had. 
The second I got her to the toilet and she sat down…she yelled “GET OUT!!! NOW!!!”
Now I’m all about giving privacy…but when it comes to unsteady 88 year old women, especially one on narcotics, unsupervised in the bathroom…I’m not that stupid.  Then the IV pump at the bedside started to go off…so I did the only thing I could think of.  I told her to stay sitting,  closed the door just enough to give privacy and ran to the bedside to fix the pump.  Suddenly, I heard the bathroom door slam.  I quickly turned to the husband.  “Please tell me that was you?!”
He shook his head.
I ran to the door and tried to turn the handle.  It was locked!!  Of course…Wait…Our bathroom doors lock????!!!!  “Sweetie are you okay?”
Nothing, it was completely quiet in the bathroom.  So I acted like a little child.  I knocked on the door, when that didn’t work…I pounded on the door…and when that didn’t work…I pounded on the door and screamed her name…still NOTHING. 
All my yelling brought about the rest of my co-workers.  When they saw what was going on…they all looked at me and said…”The bathroom doors lock???!!!”  I tried to stay calm…but man I was about ready to kill them… “Uh no they don’t lock…I’m just standing here like an idiot beating up the door!”
I started to do something as a nurse you shouldn’t ever do…I started to panic…and it takes a lot to make me panic.
I dropped to the floor and laid my face on the cold, germ-infested floor.  I could see a gown, but nothing else on the floor…well that’s good…she hasn’t fallen at least…has she!!!!???
I called environmental services and security.  Minutes later, they showed up and looked at me and said… “I didn’t know those doors locked”. 
Oh great…now what in the world am I supposed to do.  I grabbed my scissors and attempted what I later found out looked really funny.  I attempted to pick the lock…of course my scissors didn’t work. 
As I’m trying to play petty theft, I start to hear the husband going crazy.  “Helen…I mean it you need to come back here.  You need to leave those tigers alone!!! Now I said come here.  Those bears are going to get you and then you will be sorry!” 
Uhm…What in the world?
The husband is pacing around the room…when we try to reorient him, he looks at me.  “Who the blast are you…and what did you do with my pickle?”
(Now any other time, this would have been pretty entertaining…but at that moment…I could have strangled him and everyone else)
The tech helped him over to the bed to sit down.  I returned to pounding on the door and screaming my patient’s name.  Of course, still no answer.   I just knew that my patient was on the other side of that door…dead. 
The husband was on the bed trying to punch the tech in the head…and was cussing and swearing up a storm at him.  And of course, all of the other patients were going crazy on their call bells, IV pumps were beeping and doctors were wanting to speak with me.  So this is what it feels like to suffocate and almost die from stress. 
Then in the midst of all the chaos, a patient from another room, just happened to be walking down the hallway, and he poked his head in wanting to see what all the excitement was. 
Just about that time…the bathroom door opened.  Everyone…the husband, the techs, myself, the two other nurses, the security guard, the HOA, the environmental services person and of course the other patient all crowded into the bathroom to see what had happened to the patient. 
And there stood the patient, butt-naked, holding her arms in the air, pumping with victory.  She had pulled out her PICC line (of course), and disconnected her catheter from its drainage bag.  The bag was above her head in her left hand, and the catheter was hanging straight down, streaming urine.  There was blood and urine everywhere. 
I am absolutely sure, we were all standing there with our mouths wide open…not exactly believing what we were seeing.  She slowly lowered her arns, and then raised her finger and pointed at me.  “Get her away from me, she is trying to kill me.”  UM…EXCUSE ME…WHAT!!!!
I saw everyone trying not to laugh and failing miserably.
“Please call the police, I would like to report an attempted murder.”  She said, glaring at me. 
Everyone looked at me…I didn’t know whether to laugh, cry or to scream.  “What…um…what…uh…I’m not trying to kill you”, is all I could say. 
“You thought I was asleep…but I tricked you…I was only pretending.  I heard you…You and my husband…I heard you both.  You are plotting to kill me so you can run off together.”
The almost 90 year old man looked at me and whispered, “I’m so sorry”.  I did my best to smile back at him.  I will never live this down.   . 
My preceptee took over, getting her back to bed, dressed, new catheter, new IV, and removed the PCA, while of course I had the privilege of calling the doctor at 0400.  She was really nice…of course after she laughed hard core at me.   OMG…really…and then the teasing started.  “Alicia, you never mentioned that you have a thing for 90 year old men…I didn’t know you had a grandpa complex.”  And so it begins…yet again.