no balls

i took care of a young patient yesterday. she has a history of substance abuse use and somehow, we thought giving her a transplant was a good idea. i would never suggest that an addict doesn't deserve or shouldn't get a transplant. but certainly, it's a challenge. i would say the majority of our patients end up on anxiolitics (used for nausea prevention and anxiety) and narcotics (for bone pain, abdominal pain, mouth pain, etc.). and of course, these drugs are in high demand amongst users and get a pretty penny on the streets.

it would be one thing if this young gal had a good support system. but she doesn't. she has a boyfriend who is non-compliant with our hospital's rules. and as the nurse, i was told to watch my patient swallow ALL of her medications so that he doesn't steal them. even then, i wasn't sure things were happening appropriately at all times. patients can pocket meds in their cheeks for quite some time. but instead of checking my patient's mouth after she swallowed, i decided that if her loser boyfriend was desperate enough to steal half dissolved narcotics from a cancer patient he supposedly loved and cared for, so be it. i almost wished he stole all of her meds (including stool softeners) and gave himself a raging case of diarrhea!

the most interesting part of my day with her yesterday was when her bronchoscopy was cancelled. we were supposed to do a rather invasive procedure at the bedside. i was to give her boatloads of medication to sedate her and pulmonologists (lung doctors) were going to stick a camera down her nose and throat and into her lungs. for four hours prior to the procedure, she was supposed to abstain from food or drink. but the physicians caught her eating a bite of mac 'n cheese. instead of telling her right then and there that the procedure was cancelled, we went along with our plans... she and i both thought the procedure was a go at 4pm. at 4:10 though, the physicians walked in the room and called it off. i was ready with LOTS of drugs in hand and the patient was "ready" as ever. so when they called it off, she got PISSED! to say the least.

there were four letter words. she called the doctors "lazy" and said they "didn't care," that they "must have better things to do." but in reality, the cancellation was for her safety. she didn't understand the severity of having food in her belly. she didn't know that she could vomit, aspirate, and cause even more difficulties for her already damaged lungs. the doctors tried to explain the rationale to her, but she was NOT listening. i've gotten some courage in my almost 6 years of nursing. so i stepped in and tried to help explain the matter, defending the two doctors at my side. but it didn't work. as the doctors walked out of the room, recognizing that there would be NO resolution to her anger, my 22 year old patient yelled after them, "what is your name anyway? you have NO balls!"

i've witnessed some interesting interactions between patients and physicians. i've participated in strange conversations between patients and nurses. but this was the icing on the cake! i would not tell a physician he had no balls (to his face). especially when the procedure was re-scheduled for this morning and he would be sticking a camera down my throat!