We Didn't Want To Get Cold

I have worked with many nurses in my career and often hear; “Oh I just love old people, they’re so wise and have done so much for this country”. Well, spend some time at a hospital where a pediatric patient is someone 65 years old and you may change your mind. One of the papers I had to write for my graduate program required me to research reading and comprehension levels for different age groups. After spending time at one of the premier old farts hospitals in the United States, I could have told the researchers what they would have discovered without them spending the time and energy to conduct the research. Many old people are just plain stupid. I have often found myself commenting and wondering how someone can get to be so old and so stupid at the same time.

This is not elderly bashing. Hold your flaming e-mails until I explain a few things and I think you will change your mind. Moreover, if you don’t change your mind, go piss up a rope somewhere because I really couldn’t care less. Before proceeding, I should explain a little about what nurses have to do as part of their job. This is not a bitch about nursing, and even if it is, I have earned the right to criticize, complain, and deride nursing as I have walked the walk.

I’ve been a nurse for 14 years and have cared for thousands and thousands of patients. I have taught nursing to all levels of student nurses and dealt with perennially bitchy ICU nurses who think they are gods. Sorry ICU bitches, you’re not gods, and you can’t even function in my normal work environment. However, I digress; this topic is a rant I will reserve for a later article.

Nurses have to deal with every patient that ends up on their unit. It can be particularly bad when you are working in the emergency room because you are assigned patients by beds, not level of acuity. If the charge nurse puts a repugnant patient in one of your beds, you have to take care of him/her. As nurses, we have to attend to all the patient’s needs depending on the severity of the illness. Many old farts take advantage of this when they come to the ER.

I have walked old bags from triage to their room and even before they sit down, they are asking for a bedpan. Wait, you just drove yourself here, you sat in triage, walked to the room, and now you want a bedpan? Yea, I don’t think I can make it to the bathroom. My first thought is; what do you do when you are at home? Is there someone there to place a bedpan for you or do you just pee on the floor? Sometimes the answer is; I pee on the floor, and after riding with paramedics to some of these houses, you realize that is really what happens.

I have gotten into many fights with touchy-feely nurses that cater to every whim of the patient. What the touchy-feely nurses don’t understand is that while they take 20 minutes to help a non-bed bound patient use a bedpan, I am taking care of all of their patients and mine to boot. The bathroom is right there! I have told many patients. I am not going to give you a bedpan when you are capable of using the bathroom on your own. This is a hospital not a spa; I am a nurse not a butler (even butlers don’t wipe up shit) or personal attendant. This is not a resort, this is a hospital where we care for sick patients.

There are times when we have to roll the patient over and clean the shit from their butt-cheeks, that’s just part of the job. We don’t have the time, nor the desire to clean up shit when the person has the ability to do it for themselves. With staffing always inadequate because the hospitals are always trying to make more, and more, and more money, we just don’t have time to play personal attendant.

My friend John, an emergency room technician, took a new patient to his room. The patient had driven himself to the ER. He had walked to triage and waited until we had a bed for him. He walked to the room under his own power with his toupee of white curly hair almost on straight. He undressed himself, lied down on the bed, and rested his head on the pillow. With his head resting on the pillow, pressure was applied to the back of the toupee, causing it to rise at the front like a baseball cap being pulled up so one can see from underneath the bill.

John pulled the curtain back so as to open the room up a little and make it feel less claustrophobic. Mr. Toupee looked past me and straight at John. His ass rose from the bed and a loud liquid farting-bowel sound was heard. A big smile spread across the patients face, still looking straight at John he said, “Now you have to clean me up.” I wanted to grab the patient by the neck and rub his nose in the shit as one might do to a puppy. You could see color beginning to come into John’s face. He remained motionless and stoic. After about 30 seconds, John, still staring directly into the patient’s eyes, said, “I’m busy, now you have to lay in it”, and walked from the room. I don’t know who cleaned up the old fuck because I never did and I know John never did. This ancient piece of trash shit on himself on purpose and expected us to clean him up.

Old farts come to the ER expecting to be admitted to the hospital. We call it a suitcase sign because they are frequently toting a suitcase. It just does not work that way anymore. We have to have a medical reason to admit patients to the hospital. There are not enough beds to randomly give old farts a vacation from the responsibility of taking care of themselves. Gone are the Dr. Kildare days of medicine where one checks into a hospital to “get some rest”. Where a physical took three inpatient days at the hospital. It’s been this way as long as I can remember yet these old people still show up expecting treatment as if they were at a five star resort. It’s a hospital folks, come to grips with it. It’s not going to change as long as there are greedy hospital administrators running the show. And, with the numbers of baby-boomers flooding healthcare, the situation is only going to get worse.

So, there I was working an evening shift at the old farts hospital. The patch radio started buzzing, signaling a soon to be arriving patient. The charge nurse took the initial information from the paramedic and retrieved the doctor to finish the patch. In other states I have worked the doctor would walk away from the patch radio if the paramedic couldn’t give a report in 90 seconds or less. This being the stupid state, as I prefer to call it, the paramedics have the annoying habit of actually believing we give a shit about what they have to say. So, as the paramedic rambled on, I lost interest and went back to caring for my patients.

The charge nurse came around and told me that we were going to get two patients shortly. Meaning the paramedics were going to screw around with the patients for 30 minutes or so before bringing them to us. Apparently there had been a fire and two elderly people were rescued from the home. The patients were conscious and speaking when the paramedics arrived, but had some degree of smoke inhalation. The charge nurse called respiratory while I set up the trauma room for the new patients.

The paramedics finally arrived and wheeled the first patient into the ER. He had a non-rebreather 02 mask on and was coughing in fits. His face was black with soot, tears streamed down his face carrying the soot in black rivers down his neck. He truly looked the part of an old shriveled prune. A coughing in fits and spasms prune, but a prune nonetheless. His wife arrived shortly after and looked much the same. The blue terry cloth robe she was wearing would probably never be free of the smoky-sooty smell from the fire.

While the old couple participated in stereo spasms of coughing and gasping for air, the paramedics filled us in on the scene. The 911 call had been placed by a lady saying their home was on fire. Two engines and a ladder truck were dispatched along with one ambulance. Upon arriving at the residence the firefighters did not see anyone standing outside waiting for them. They approached the front door and peered inside. Externally no smoke could be seen, but inside they could see a thick layer of black smoke billowing down from the ceiling leaving about 4 feet of clear air near the floor.

The firefighters broke the glass on the door, turned the three locks on the door and entered the home. The firefighter told me that breaking the glass on the door bothered him the most. Not knowing if the rush of oxygen from the broken window would ignite a flashover is a sure adrenalin rush. Crawling through the home the firefighters began yelling to see if anyone was inside. Through a partially closed bedroom door they could hear a weak female voice responding “we’re in here.”

The firefighters entered the bedroom through the open door and found the old couple still in bed. The firefighter related the scene to me. The old couple had about six blankets on the bed. Somewhere in the pile of six blankets they had layered an electric blanket. Because the electric blanket was old, turned up on high, and under several other blankets, it had smoldered for a while and then burst into flames. When the firefighters arrived the old couple was still laying in the bed. They pulled the old couple from the bed and dragged them outside.

After listening to this story I went back to the trauma room with the firefighter and asked the old man why he did not get out of a bed that was consumed in flames. His wife spoke up, “we didn’t want to get cold.”

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