The anesthesiologist and nurse pushed the stretcher with the patient still intubated. Her arm was in a splint with a white sterile dressing from her hand up and over to the bend in her elbow. Very sleepy….not waking up any time soon. No problem. I know what to do. OXYGEN via T piece. Sit close to bedside. Watch her like a hawk. Have suction ready. Anesthesia nearby and on alert. Keep trying to wake her. Get her to open her eyes. Open her mouth. RESPOND. Sternal chest rub. Ear rubs. Monitor BP, HR, breathing! Why is she not waking up?
Finally she wakens. Breathing tube out. Oxygen continues. Eyes open. I ask her about pain. She says it hurts. I give her IV pain medication. She appears to be more awake. Vital signs stable. This goes on for TWO HOURS and then she asks me, “is it all done?” What ….who have I been talking to?
“Yes, you’re all done. Everything went well. You are in the recovery room,” I answer. Scratching my head I’m wondering what’s going on.
She has to pee which as everyone knows is a turning point. Unhooked from monitor. Stretcher moved close to bath room. Patient sits on edge of bed. Then…..with 2 nurses she takes baby steps to the bath room. She voids. YIPPPPEEE! Into recliner. Now we’re making headway.
Time for her friend/ride home to come into PACU. Let me see what is the friends name. Mari J Uanna. I’ll call into the waiting room, “is there a Mari J. Uanna. STOP. Oh no! What a Dumb Dora I am!” Mari Jane…….Marijuana! Marijuana? What? The nurse that got her ready for surgery wrote right on top of the “person to call for ride home” spot that the patient had smoked marijuana the night before the surgery. She might have smoked it on the way into surgery this morning. The plot thickens.
Whewwww that was a close call. No matter. She is awake now and reports pain in her lower back? What? The surgery was on the arm. She tells me, “my back hurts.”
“Why does your back hurt”, I ask.
“I fell out of bed last night.”
“Did you tell anyone about this?” “Yes, but not the doctor”, she responds in a slurred voice. Let me get this straight your arm feels okay, but your back hurts a lot…..right? I can’t ignore this information. What if she broke something or fractured a rib? I message the surgeon and fill him in on the scenario.
Not a minute later he comes into PACU and goes right to the patient. He asks her how she’s doing. She says, “Fine.” He asks her how’s the pain. She says, “not bad.” I can’t believe what I’m hearing.
Something’s fishy in Denmark.
He looks around and says, “where is your nurse!” I’m right here. He looks at me with his beady little eyes and says in an accusing, why are you bothering me tone, “she says she feels fine.”
In a forced calm voice I say to the “stoned” patient, “that is not what you told me 5 minutes ago. What about falling out of bed at 2:30am (thinking to myself….probably on your way to get some munchies!) Didn’t you tell me that you fell out of bed last night and that your back hurts a lot? Didn’t you?”
In a crooked smile she responds, “well… yeah. My husband said I shouldn’t sleep so close to the edge of the bed cause I’m going to fall out. I guess I did.”
Seriously. Really. Come on.
This is the kind of thing that patients can do. Under the influence of medications for pain …not to mention being “stoned” they can throw their loving caring nurse right under the bus. I tried to put the fear of GOD into her by telling her, “do not smoke pot while taking pain medication. You could get into serious trouble like falling and breaking your other arm.”
Luckily we, the PACU nurses, have a wonderful rapport with our doctors and they know a bus accident when they see one. It’s a delicate line winning rapport with your patient and the surgeon and the anesthesiologist. That is why we get paid the big bucks. NOT!
TIDBIT During Florence’s time they did not have buses. I wonder if nurses got thrown under the horse and buggy now and then. Ouch.